THE  LIBRARY 

OF 

THE  UNIVERSITY 
OF  CALIFORNIA 

LOS  ANGELES 


THE  HISTORY  AND  PRACTICE  OF 
PSYCHANALYSIS 


RATIONAL  SEX  SERIES 


SAKE  SEX  LIFE  AND  SANE  SEX  LIVIKO, 
by  H.  W.  Long,  M.D. 

BI-SEXUAL  LOVE,  by  Dr.  William  Stekel. 

THE  HOMOSEXUAL  NEUROSIS,  by  Dr.  Wil- 
liam Stekel. 

SEX  AND  DREAMS,  THE  LANGUAGE  OF 
DREAMS,  by  Dr.  William  Stekel. 

SEX  AND  THE  SENSES,  by  James  8.  Van 
Teslaar 

THE  LAWS  OF  SEX,  by  Edith  H.  Hooker 

MOTHERHOOD,  by  H.  W.  Long,  MJ). 

CHILDREN  BY  CHANCE  OR  BY  CHOICE,  by 
William  Hawley  Smith 

SEX  IN  PSYCHO-ANALYSIS,  by  S.  Fe- 
renczi,  M.D. 

HISTORY  AND  PRACTICE  OF  PSYCHANALY- 

sis,  by  Poul  Bjerre,  M.D. 
TEMPERAMENT    AND    SEX,    by     Walter 

Heaton 

SEX  AND  SOCIETY,  by  W.  I.  Thomas 


RICHARD     G.     BADGER,     PUBLISHER,     BOSTON 


THE 

HISTORY  AND  PRACTICE 
OF  PSYCHANALYSIS 

BY 

POUL  BJERRE,  M.D. 

Authorized  Translation  by 
ELIZABETH  N.  BARROW 


REVISED  EDITION 


BOSTON 

RICHARD  G.  BADGER 

THE  GORHAM   PRESS 
LONDON:  STANLEY  PHILLIPS 


COPYRIGHT,  1916,  BY  RICHARD  G.  BADQEB 
COPYRIGHT,  1920,  BY  ELIZABETH  N.  HARROW 


All  Rights  Reserved 


Made  in  the  United  States  of  America 


The  Gorham  Press,  Boston,  IJ.  S.  A. 


WM 


The  translator  desires  to  express-  keen  appreciation  ol 

the  valuable  assistance  given  in  this  work 

by  Ebba  Tisell 


INTRODUCTION 

years  ago  when  this  book  was  written,  it 
^-^  already  seemed  to  me  that  its  subject  matter  be- 
longed to  history  and  now  the  theories  of  Freud  and 
Adler  appear  almost  as  antiquated  as  those  of 
Feuchtersleben  and  Liebault.  It  was  not  however 
because  of  this  historical  interest  that  the  book  came 
into  being.  The  present  and  the  future  always  en- 
gross me  sufficiently  to  absorb  all  my  attention.  But 
when  I  took  over  Wetterstrand's  practice  as  a  spe- 
cialist in  psychotherapy  in  Stockholm,  I  quickly 
discovered  that  I  could  not  keep  on  where  he  had 
left  off.  Even  more  impossible  did  I  find  it  to  feel 
at  home  in  the  new  systems  and  methods  of  treat- 
ment that  had  grown  up  and  begun  to  control  psy- 
chotherapeutic  thought.  In  trying  to  follow  any  one 
of  the  leaders  in  psychic  treatment,  I  found  my  re- 
sults poor.  On  the  other  hand,  when  I  examined  each 
case  individually,  following  only  the  suggestions 
which  just  that  case  alone  presented,  my  progress 
was  satisfactory.  Finally  as  practical  experience  ac- 
cumulated, I  found  I  must  try  to  make  it  conform  to 
the  new  theoretical  trends  of  thought. 

7 


8  Introduction 

But  science  is  not  made  up  of  the  experiences  and 
thoughts  of  solitary  investigators.  Science  is  the 
common  spiritual  structure  of  humanity,  to  which 
each  one  must  contribute  his  forces  where  they  are 
best  adapted.  It  is  therefore  applicable  that  each 
discussion  begin  with  an  historical  introduction, 
which  step  by  step  leads  up  to  the  point  where 
the  new  effort  to  solve  the  problem  sets  in.  When  I 
tried  to  present  my  experience  in  one  complete  vol- 
ume, I  was  forced,  in  spite  of  myself,  to  first  look 
over  the  ground  on  which  psychotherapy  had  been 
built  up. 

This  work  grew  into  a  volume  by  itself. 

In  the  history  of  medicine  there  is  something  called 
odium  medicum.  Physicians  have  made  a  bad  repu- 
tation for  themselves  by  dividing  into  schools  which 
have  struggled  so  hotly  against  one  another  that  for 
the  struggle's  sake  they  have  lost  sight  of  the  com- 
mon goal  that  stands  above  all  strife — namely,  the 
search  for  truth.  The  modern  psychotherapeutists 
have  far  outstripped  their  colleagues  in  this  re- 
spect. Added  to  this  the  older  academic  physicians 
have  spared  no  pains  in  the  attempt  to  throw  sus- 
picion on  the  whole  psychotherapeutic  movement. 
Consequently  none  has  calmly  considered  the  vari- 
ous contributions  to  this  subject,  with  endeavor  to 
separate  the  real  and  lasting  from  what  is  worth- 
less and  incidental.  Being  little  interested  in  the 


Introduction  9 

small  controversies  of  the  day,  I  have  made  attempt 
to  take  this  task  upon  myself.  Instead  of  keeping 
to  the  historical  point  of  view  exclusively,  I  tried  to 
crystallize  from  it  whatever  was  likely  to  attain  real 
value  when  controversy  was  over.  I  kept  to  few 
names;  originators  are  rare; — not  so  followers. 
History  deals  only  with  the  former.  Especially 
where  Freud  was  concerned  have  I  found  it  hard  to 
draw  the  line  between  what  is  the  out-crop  of  genius 
and  what  is  absurdity.  Some  effort  in  this  direction 
I  made  in  a  lecture  delivered  in  Munich  at  the  Psy- 
chological Congress,  1913.  The  gist  of  this  lecture 
is  here  given  under  the  caption,  "The  Conscious 
Versus  the  Unconscious."  To  illustrate  how  the  dif- 
ferent trends  of  thought  actually  assimilate  in  prac- 
tice, I  added  my  paper  entitled  "Extract  from  a  Case 
History." 

After  the  historical  introduction,  I  took  hold  of 
something  that  more  nearly  appealed  to  me — name- 
ly the  revision  of  the  material  gathered  during  prac- 
tice, from  that  new  standpoint  at  which  I  had  ar- 
rived. First  of  all  this  meant  attempt  to  give  the 
enduring  fundamental  idea  that  firm  and  monu- 
mental form  the  idea  must  have,  if  from  its  height 
one  is  to  survey  anything  so  extensive  as  the  phe- 
nomena of  mental  disease.  I  was  confronted  here 
with  a  task  that  was  of  a  philosophical  or  purely 
religious  nature,  rather  than  a  medical  one. 


10  Introduction 

One  thing  strikes  one  forcibly  in  modern  psycho- 
therapy. It  investigates  not  alone  as  science  the  dif- 
ferent forms  in  which  spiritual  decay  comes  to  the 
surface  in  anxiety-states,  insanity,  etc. ;  but  as 
therapy  too,  it  attempts  to  help  man  overcome  that 
spiritual  death  and  reach  harmonious  security  on 
the  other  side  of  it.  It  should  then  be  clear  that  its 
whole  activity  circles  about  the  idea  of  spiritual 
death;  but  what  strikes  one  is  that  instead  of  domi- 
nating the  scientific  literature,  this  idea  has  disap- 
peared from  it.  This  is  the  more  surprising  since 
every  unprejudiced  observer  must  at  once  be  aware 
of  this  inner  struggle  between  life  and  death,  as  soon 
as  he  comes  into  contact  with  this  class  of  patients. 
It  may  be  reflected  in  different  ways,  but  putting 
aside  contingent  details,  the  same  essentials  are  al- 
ways met  with.  As  a  rule,  too,  it  is  the  more  obvious 
because  most  patients  come  for  treatment  just  when 
they  are  on  the  point  of  succumbing  to  life's  negative 
forces. 

Unless  viewed  in  connection  with  the  time  during 
which  psychotherapy  originated,  it  is  hard  to  un- 
derstand this  peculiarity.  It  was  the  materialism  of 
that  time,  placing  its  stamp  here,  as  well  as  upon 
science  and  art  in  general,  upon  the  social  struc- 
ture,— indeed  upon  everything.  This  fact  is  sin- 
gularly grave,  because  it  should  be  the  special  duty 
of  psychotherapy  to  be  a  powerful  means  of  fight- 


Introduction  11 

ing  materialism; — it  teaches  exactly  that — how 
hopeless  it  is  to  try  to  overcome  spiritual  death  in 
material  ways  and  by  material  means. 

When,  therefore,  one  feels  driven  to  again  take 
up  the  time-honored  problem  of  spiritual  death  for 
renewed  examination,  it  is  necessary  to  guard  against 
one  danger.  This  very  problem  was  what  formerly 
gave  rise  to  the  different  forms  of  religion,  the  de- 
cay of  which  our  day  has  witnessed.  Habits  of 
thought,  symbols,  phraseology  and  dogma  in  which 
religion  was  clad,  still  have  great  influence  over  us. 
We  have  a  natural  tendency  to  slip  into  old  re- 
ligious ways  of  speaking  and  of  clinging  to  its  dis- 
tinctions. But  surely  this  means  that  by  creating 
anew  we  shall  get  beyond  what  has  been,  to  a  new 
formulation  of  the  old  problem,  with  new  distinctions, 
which  can  become  a  guiding  force  for  the  future. 
Science  must  not  be  forced  back  into  primitive  forms 
of  the  spiritual  life;  on  the  contrary  science  must 
be  lifted  to  a  higher  plane,  that  it  may  grapple  with 
the  highest  manifest  forms  of  existence,  precisely 
as  it  took  hold  of  the  material  world  during  the  past 
century.  Out  of  inner  force  it  must  reach  final 
clearness. 

But  this  task  of  drawing  a  line  between  life  and 
death  in  the  spiritual  meaning  from  the  fully  up- 
to-date  standpoint,  has  grown  into  a  book  by  itself. 
It  bears  the  name  "DEATH  AND  REGENERA- 


12  Introduction 

TION"  and  comprises  three  volumes,  of  which  the 
first  has  just  been  published.  In  a  series  of  con- 
centrated aphoristical  chapters,  I  try  to  make  clear 
the  two  fundamental  phenomena  of  spiritual  death 
— disintegration  and  mechanization.  I  characterize 
the  different  human  types  from  these  standpoints. 
In  another  series  of  chapters,  which  I  have  called 
"Sacrifice  and  Atonement,"  I  try  to  show  how 
spiritual  death  may  be  overcome.  The  second  volume 
of  this  work  will  treat  of  the  social  structure  and 
the  third  of  the  last  great  question  of  our  existence. 

Only  from  the  other  side  of  the  viewpoint  thus 
won  and  from  the  help  thus  attained,  does  it  seem 
possible  to  me  to  straighten  out  the  numberless  de- 
tailed problems  of  nervous  disease.  The  work  in 
which  I  hope  to  point  the  way  to  this  and  to  which 
these  three  volumes  also  are  a  kind  of  introduction, 
will  be  entitled  "FROM  PSYCHOANALYSIS  TO 
PSYCHOSYNTHESIS."  With  this  title  I  shall 
have  said  in  advance  that  the  analytical  side  of  the 
matter  is  not,  to  my  mind,  the  most  important.  Of 
far  greater  import  is  it  to  obtain  clear  understand- 
ing of  those  forces,  due  to  which  man  may  be  built 
up  into  a  united,  harmonious  being,  bearing  witness 
of  the  divineness  of  his  inmost  nature. 

POUT,  BJERRE. 
Varstavi,  Tumba,  Jan.,  1920. 


CONTENTS 

CHAPTEB  PAQB 

I.     KANT  AND  FBUCHTERSLEBEN 17 

TI.     WETTERSTRAND  AND  THE  NANCT  SCHOOL  ....  43 

III.  PSYCHANALYSIS  AH  A  SCIENCE  AND  METHOD  OF  TREAT- 

MENT       88 

IV.  THE  ADLEH-DOCTRINE  CONCERNING  NEUROSIS     .      .  152 
V.    THE  NATURE  OP  HYPNOSIS 198 

VI.    THE  CONSCIOUS  VERSUS  THE  UNCONSCIOUS    .     .     .  21£ 

VII.    EXTRACT  FROM  A  CASE-HISTORY 248 

VIII.     POINTS  OF  VIEW  AND  Ourixx>K8  298 


IS 


KANT  AND  FEUCHTERSLEBEN 

KANT  suffered  from  gout. 
When  such  an  actual  illness  comes  into  hu- 
man life,  it  means  not  only  the  suffering,  the  lessened 
power  for  work,  the  sleepless  nights,  the  hopeless- 
ness, but  the  evil  of  it  spreads  to  the  environment  of 
the  victim  as  well,  and  this  too  is  gradually  sub-; 
merged  beneath  an  inexorable  burden  of  fatality. 
Beyond  this  the  illness  has  also  a  negative  action, 
outside  its  immediate  boundaries;  it  endeavors  to 
force  the  entire  life  of  its  victim  into  its  power.  And 
in  this  lies  its  more  horrifying  significance.  Instead 
of  being  able  as  hitherto,  to  direct  oneself  towards 
some  positive  goal,  one  now  before  all  things,  must 
have  the  negative  purpose  in  view  of  becoming  free 
from  suffering.  Before  the  occurrence  of  such  a  mis- 
fortune, the  victim  had  been  able  to  turn  his  activi- 
ties towards  his  real  desires;  now  all  these  must  be 

17 


18         History  and  Practice  of  Psychanalysis 

set  aside  in  order  to  concentrate  his  effort  towards 
ridding  himself  of  the  guest  that  comes  thus  unbid- 
den. The  banal  man  becomes,  in  such  circumstances, 
a  victim  of  experimental  science,  dividing  his  time 
between  the  trial  of  new  methods  of  treatment  and 
complaint  concerning  the  inability  of  these  to  give 
him  the  desired  help.  He  looks  continually  for  that 
marvel  which  is  to  bring  him  salvation.  And  the 
more  the  illness  establishes  itself  as  an  incurable  one, 
just  so  much  the  more  inextricably  bound  up  in  it, 
becomes  the  environment  of  the  invalid. 

But  for  one  who  is  wise,  each  new  fact  becomes  a 
spur  to  renewed  reflection  and  before  each  new  per- 
ception, no  matter  how  painful,  such  a  one  stops  to 
ask  if  there  is  not  something  to  gain  from  it,  some- 
thing to  add  to  his  store  of  knowledge.  If  he  is 
successful,  then  a  re-valuation  occurs ;  even  out  of 
the  seemingly  most  negative  condition  there  radiates 
something  of  the  imperishableness  of  life.  And  all 
that  surrounds  him  takes  its  part  in  this. 

When  Hufeland  wrote  his  book  on  the  art  of  pro- 
longing life,  he  sent  it  to  Kant  as  a  "token  of  that 
appreciation  which  every  thinking  human  being  owes 
to  this  wise  man;"  and  also  "to  cause  him  to  con- 
sider some  ideas  therein  set  forth,  which  belong  to  the 
philosophical  tribune."  Kant  replied  with  a  little 
pamphlet  which  he  called :  "The  Power  of  the  Mind, 
Through  Simple  Determination,  to  become  Master 


Kant  and  Feuchtersleben  19 

over  Morbid  Ideas."    And  in  this  he  devotes  one  page 
to  the  subject  of  his  gout. 
He  relates : 

In  order  that  my  sleep  should  not  be  interfered 
with,  I  at  once  seized  upon  my  stoical  remedy,  that  of 
directing  with  effort,  my  thoughts  towards  some 
chosen  indifferent  object,  for  example,  towards  the 
many  associated  ideas  brought  up  by  the  word 
Cicero.  In  this  way  I  led  my  attention  away  from 
every  other  idea.  Thus  these  became  quickly  blunted, 
so  that  sleepiness  could  overcome  them.  And  this  I 
am  always  able  to  repeat  in  attacks  of  this  kind  with 
a  like  good  result.  That  I  had  not  dealt  with  imagin- 
ary pain  was  clearly  evident  the  following  morning 
when  I  found  the  toes  of  my  left  foot  swollen  and 
red. 

His  attacks  of  gout  thus  became  for  Kant  a  source 
of  inner  investigation  and  from  this  source  issued  a 
new  stream  of  wisdom.  Nevertheless  of  any  positive 
signification  regarding  this  illness,  no  thinker  of  his 
time  got  an  intimation;  it  spread  itself  far  through 
the  time  to  come,  to  future  generations.  I  think  one 
may  say  that  no  book  has  had  so  strong  an  in- 
fluence upon  the  development  of  psychotherapy  as 
have  these  few  simple  pages,  acting,  as  they  have 
done,  as  an  inspiration  for  many  others  who  since 
have  taken  up  these  studies.  I  have  recently  read  a 
paper  by  one  of  our  most  modern  writers,  in  which 


20        History  and  Practice  of  Psyclianalysis 

he  says,  that  when  questioned  by  patients  as  to  what 
they  ought  to  read,  he  answers:  Kant  and  Feuch- 
tersleben. 

Wherein  then  lies  what  is  most  essential  in  these 
experiences  of  Kant? 

First  the  title  given  to  his  book  "The  Power  of 
the  Mind,  Through  Simple  Determination,  to  Be- 
come Master  over  Morbid  Ideas."  There  exists  in 
other  words,  the  possibility  of  causing  changes  in 
morbid  processes,  through  psychic  means.  Upon, 
the  unshakableness  of  this  fact  all  psychotherapy 
finally  depends.  And  Kant  succeeded  in  driving 
home  this  fact  for  himself  with  singular  surety. 
Philosophers  of  a  whole  century  have  in  vain  racked 
their  brains  to  disprove  him  on  other  points.  I 
suspect  that  all  efforts  to  prove  him  false  on  this 
question  will  also  necessarily  come  to  naught.  For 
Kant  has  not  advanced  this  as  a  theory  and  it  has 
therefore  no  part  in  the  transitoriness  that  is  in- 
herent in  all  theories.  Neither  did  it  come  about 
through  the  casual  observation  of  an  objective  oc- 
currence. Those  who  have  been  brought  up  to  be- 
lieve in  the  prevailing  dogma  that  objective  study  of 
material  phenomena  is  the  only  thing  that  gives  us 
real  knowledge,  automatically  oppose  themselves  to 
everything  which  implies  a  glimmer  of  effort  toward 
a  trial  to  reduce  the  security  upon  which  such  science 
is  founded.  But  it  is  all  too  easy  to  forget  that 
til  objective  research  is  based  finally  upon  our  men- 


Kant  and  Feuchtersleben  21 

tal  impressions  and  that  some  certain  amount  of  illu- 
sion always  remains  bound  up  with  these.  Partly 
because  they  never  can  be  trained  to  an  absolute 
degree  of  sharpness;  partly  and  above  all,  because 
they  never  can  be  wholly  isolated  from  physical  oc- 
currences. No  matter  how  conscientious  an  investi- 
gator may  be,  he  never  can  quite  free  himself  from 
seeing  that  which  he  wishes  to  see  more  clearly  than 
that  which  he  does  not  wish  to  see.  This  is  one  rea- 
son for  the  gross  mistakes  made  by  science,  which 
have  won  admittance  to  the  general  consciousness. 

The  only  thing  about  which  we  really  know  some- 
thing with  certainty,  is  that  which  we  experience  in 
our  inner  lives.  This  is  true  more  especially  if  these 
experiences  are  of  such  vital  importance  that  they 
take  their  place  as  integral  constituents  in  our 
thought  and  volitional  life.  So  Kant's  fixation  of 
the  fundamental  fact  of  psychotherapy  occurred 
as  an  inner  experience.  It  might  have  been  possible 
to  convince  him  that  the  opinion  of  humanity  con- 
cerning the  solar  system  was  faulty:  a  new  cosmic 
genius  might  change  the  prevailing  conception  re- 
garding that,  just  as  Copernicus  changed  the  opinion 
of  his  time.  But  no  power  on  earth  could  have  dis- 
turbed Kant's  opinion  regarding  the  functioning  of 
his  organism,  which  had  been  formed  in  connection 
with  his  experience  as  above  cited.  These  closely 
observed  inner  experiences  go  to  the  kernel  of  that 
which  is  out  of  our  reach  by  any  other  path.  Knowl- 


22        History  and  Practice  of  Psychanalysis 

edge  gained  in  this  way  is  established  unchangeably 
for  the  coming  centuries,  while  numberless  theories 
arise  and  burst  like  soap-bubbles,  and  while  our  con- 
ception of  the  whole  world  may  change  its  form  and 
color. 

If  this  possibility  of  causing  real  changes  through 
inner  work  did  not  exist  in  the  whole  of  that  sphere 
of  phenomena  which  is  gathered  under  the  name  of 
disease,  the  psychic  treatment  of  disease  would  be 
nothing  but  an  illusion.  That  which  one  believed 
to  be  happening  would  be  only  imagination,  which 
soon  would  be  put  to  flight  before  reality.  It  is  the 
object  of  these  studies  to  carry  this  fundamental 
fact  farther  along,  to  point  out  some  ways  in  which 
changes  may  be  brought  about  and  to  draw  up  the 
limits  within  which  these  are  possible.  I  shall  occupy 
myself  exclusively  with  functional  disturbances,  leav- 
ing organic  diseases  to  the  various  branches  of  medi- 
cine to  which  they  belong. 

That  vulgarizing  of  psychotherapy  which  goes 
under  the  name  of  Christian  Science,  makes  an  effort 
to  maintain  that  by  looking  away  from  illness,  denial 
of  its  real  existence,  the  physical  destructive  proc- 
esses may  be  removed.  It  postulates  a  universal  har- 
mony; if  the  one  who  is  ill  succeeds  in  becoming  ab- 
sorbed in  this  idea,  the  disturbance  of  the  harmony 
which  we  call  disease,  also  disappears.  I  mention 
this  in  passing  for  it  has  its  interest  in  showing  how 
thought  of  the  possibility  of  removing  physical  suf- 


Kant  and  Feuchtenlcben  23 

fering  by  means  of  psychic  treatment  which  had  its 
beginning  in  Kant,  has  since  continually  been  veri- 
fied anew  by  those  who  have  interested  themselves 
in  the  subject.  Speaking  further  of  his  gout,  Kant 
said:  "I  am  sure  that  many  gouty  troubles,  yes, 
cramps  and  even  epileptic  attacks,  also  podogra, 
which  is  described  as  incurable,  can  be  warded  off 
by  a  firm  determination  to  distract  the  attention 
from  them,  and  little  by  little  they  may  even  be  got 
rid  of."  When  the  Christian  Scientist  overcomes  his 
pain  by  reading  the  effusions  of  his  prophetess,  these 
have  for  him  the  same  meaning  which  the  word  Cicero 
had  for  Kant, — it  implies  in  both  cases  the  diversion 
of  the  attention  by  the  use  of  something  with  no 
especial  meaning,  but  which  will  awaken  many  asso- 
ciated ideas.  This  is  so  clear  that  no  further  com- 
ment is  necessary. 

Kant's  psychological  dietetic  prescription  has  a 
kind  of  simplicity  which  really  is  monumental  but 
which  unfortunately  is  of  little  use  in  the  complicated 
conflicts  of  people  of  our  own  times. 

Seen  from  a  psychological  point  of  view  it  was  a 
tension  of  the  will  many  times  emphasized,  through 
which  the  attention,  by  main  force,  was  compelled 
to  take  a  new  direction.  It  is  interesting  to  note 
that  Liebeault's  working  out  of  the  idea  of  sug- 
gestion, half  a  century  later,  was  founded  on  just 
the  same  basis.  Explained  in  Liebeault's  terjnin- 
ology,  Kant  suggested  loss  of  feeling  to  himself.  As 


24        History  and  Practice  of  PsycJianalysii 

I  shall  more  closely  point  out  in  discussing  the  Nancy 
School,  Liebeault  even  made  of  the  attention,  a  kind 
of  creative  power,  existing  within  the  organism.  In 
this  there  is  a  valuable  practical  truth,  even  if  it  by 
no  means  exhausts  the  psychology  of  the  mechanism 
of  suggestion.  It  is  unfortunate  that  strong-willed 
concentration  of  the  attention  has  been  made  more 
difficult  little  by  little,  as  the  power  of  attention  has 
been  broken  up  by  the  widespread  idea-material, 
which  development  on  all  sides,  carries  with  it.  It 
was  undoubtedly  easier  for  him  who  never  saw  any- 
thing but  Konigsberg  to  concentrate  his  mind  upon 
a  single  point,  than  it  is  for  one  whose  consciousness 
is  divided  into  the  millions  of  shifting  scenes  and  im- 
pressions gathered  from  one  of  our  great  modern 
cities. 

Looking  at  the  more  philosophical  side  of  Kant's 
prescription,  one  sees  it  stamped  with  a  stoicism 
which  one  can  scarcely  read  of  without  envying  this 
concentrated  power  of  a  by-gone  type  of  humanity. 
Kant  relates,  for  example,  how  once  he  was  troubled 
with  cold  in  the  head  and  cough,  and  that  this  dis- 
turbance was  the  more  unpleasant  because  it  started 
up  in  the  night  and  prevented  him  from  sleeping. 
He  was  "indignant"  at  being  disturbed  in  his  phil- 
osophical existence  by  a  thing  so  paltry,  just  as 
someone  else  might  be  annoyed  at  being  kept  awake 
by  a  screaming  child.  Kant  decided  to  force  himself 
to  breathe  through  the  nose.  In  this  way  he  taught 


Kant  and  Feuchtersleben  25 

himself  to  suppress  the  irritation  of  the  cough  and 
shortly  it  no  longer  had  power  to  prevent  him  from 
going  quickly  to  sleep. 

The  individual  must  not  permit  himself  to  be 
imposed  upon  by  any  physical  condition  which  at- 
tempts to  disturb  his  poise, — that  is  Kant's  chief 
point. 

This  stoicism  celebrates  its  greatest  triumph  when 
that  which  encroaches  upon  the  well-being  of  the 
individual  is  of  a  kind  which,  according  to  the  law  of 
nature,  cannot  be  changed ;  in  other  words,  when  it  is 
inherent  in  the  constitution  itself.  That  which  Kant, 
in  this  respect,  had  most  difficulty  in  reconciling 
himself  to,  was  his  sunken  chest.  It  was  a  fact  that 
there  was  insufficient  room  for  free  action  of  the 
heart  and  lungs ;  he  describes  how  this  predestined 
him  to  hypochrondria,  from  which  in  his  youth  he 
suffered  almost  to  the  point  of  a  loathing  for  life. 
But  little  by  little  it  became  clear  to  him  that 
nothing  could  be  done  to  change  this  and  he  taught 
himself  to  be  "calm  and  clear  in  the  head"  although 
he  was  "oppressed  in  the  chest."  So  gradually  he 
became  master  of  this  oppression  "by  leading  away 
the  attention  from  it  as  if  it  were  no  concern  of 
his." 

This  is  an  important  point. 

The  whole  position  of  man  in  the  universe  is  such 
that  he  is  continually  under  the  influence  of  forces 
which  act  in  opposition  to  the  goal  which  he  is  striv- 


£6        History  and  Practice  of  Psychanalysis 

ing  to  attain,  and  over  which  in  accordance  to  the 
law  of  nature  he  never  can  be  master.  These  forces 
are,  so  to  speak,  a  universally  present  opposition  to 
the  realization  of  the  deepest  desire  of  mankind, — 
that  of  constituting  the  personality  as  a  self-deter- 
minate being.  Life  in  the  body  itself  is  one  such  op- 
position, continually  limiting  free  movement  even  in 
the  strongest  and  soundest  individual.  Naturally 
the  frailer  the  body,  just  so  much  the  more  limited 
is  its  freedom, — at  least  up  to  a  certain  degree. 

This  shows  itself  plainly  in  the  useless  struggle 
against  unconquerable  opposition  which  needlessly 
wears  out  the  powers  of  so  many  nervous  sufferers. 
Existence  becomes  a  protest  against  forces  before 
which  one  must  always  go  under.  There  is  but  one 
thing  to  do,  viz:  to  make  peace  with  these  forces 
under  as  favorable  conditions  as  poseible,  if  one 
would  become  emancipated  from  their  influence.  Only 
when  one  succeeds  in  doing  this  does  the  constant 
danger  of  loss  of  self-independence  cease.  Unfortu- 
nately it  is  much  easier  to  preach  such  stoicism  than 
to  carry  it  out.  A  man  like  Kant  who  in  calm  and 
peace  could  sit  in  his  study,  laying  stone  upon  stone 
to  his  thought  structure,  could  do  it.  But  the  suf- 
ferer of  today  who  is  torn  between  innumerable  dif- 
ferent occupations,  and  who  at  the  same  time  must 
stretch  his  strength  to  the  utmost  in  order  to  keep 
himself  going  at  all,  finds  it  is  more  difficult  to  ad- 
just himself  with  courage  and  equanimity  to  the  all 


Kant  and  Feuchtersleben  J7 

too-cramped  margin  which  nature  has  assigned  for 
his  powers. 

The  idea  which  Kant  gave  out  in  his  reply  to 
Hufeland's  book,  became  incarnated  in  Ernst  von 
Feuchtersleben. 

Concerning  the  outward  features  of  this  man's 
life,  I  will  mention  here  only  that  he  practiced  in 
Vienna  from  1830-1840,  and  that  his  work  is  dedi- 
cated to  those  "who  must  fight  the  struggle  of  life 
and  who  take  this  to  be  a  serious  problem." 

Feuchtersleben  wished  to  found  a  general  psycho- 
therapy upon  inner  work  directed  by  human  wisdom. 
In  his  "Lehrbuch  der  artzlichen  Seelenkunde,"  he 
does  not  connect  himself  with  the  history  of  medicine, 
but  with  that  of  philosophy.  And  he  subsequently 
tries  from  this  to  extract  everything  that  can  lay 
down  lines  of  direction  for  the  attainment  of  a  har- 
mony against  which  suffering  and  sickness  shall  have 
no  power.  In  this  effort  there  is  much  of  truth. 
All  learned  doctrines  point  finally  towards  the  over- 
coming of  inner  death  and  towards  the  attainment  of 
an  everlasting  harmony  with  existence  in  its  entirety. 
It  may  be  a  question  if  the  intellectual  faculty  of  the 
mind  itself,  when  this  is  not  directed  towards  some 
outer  practical  aim,  is  not  in  its  substance  only  one 
of  nature's  attempts  to  compensate  the  disturbed 
harmony  between  the  human-being  and  the  world ; — 
in  other  words  that  nature  in  a  round-about  way 
would  try  to  regain  something  which  had  become  lost. 


28        History  and  Practice  of  Psychanalysis 

However  that  may  be,  it  is  certain  that  wisdom  has 
its  importance  for  everyone  who  has  been  forced  out 
in  the  solitary  struggle  against  spiritual  death.  But 
the  history  of  philosophy  is,  unfortunately,  not  the 
history  of  wisdom ;  it  is  rather  a  pattern-book  of  hu- 
man errors.  However  hard-pressed,  little  can  be  ob- 
tained from  it  that  will  serve  as  a  draught  of  life- 
giving  water  to  one  who  is  parched  with  thirst.  Had 
psychotherapy  no  other  source  to  rely  upon,  then 
would  it  never  have  attained  the  right  to  exist.  The 
condition  of  things  between  it  and  philosophy  must 
rather  be  changed  about.  Psychotherapy  must  go 
its  own  road ;  the  knowledge  its  users  need,  they  must 
try  to  reach  directly  through  the  study  of  that  which 
they  experience  among  the  sick.  If  it  succeeds,  little 
by  little  in  coming  upon  more  generally  applicable 
rules  for  the  breaking  up  of  conflicts,  freeing  from 
anxiety,  controlling  disease,  then  it  is  possible  that  a 
truer  doctrine  of  wisdom  than  that  of  the  old  phil- 
osophy can  be  built  up  upon  this  basis  of  experience, 
which  concerns  life  and  the  perils  of  life. 

What  is  of  most  interest  about  the  works  of 
Feuchtersleben  is  not,  however,  his  attempt  to  found 
a  new  branch  of  therapy.  It  is  the  reflexions  he 
makes  concerning  disease,  with  this  attempt  in  mind. 
And  these  have  greater  value  as  they  the  more  spon- 
taneously, directly,  spring  from  his  own  suffering. 
By  far  the  best  thing  he  wrote  seems  to  me  to  be  his 
diary.  There  may  be  found  in  short  clear  sentences, 


Kant  and  Feuchtersleben  29 

most  of  what  has  value  in  all  the  popular  literature 
concerning  nervous  diseases,  which  followed  closely 
upon  his  work.  And  what  is  of  far  greater  inter- 
est,— here  are  again  found  very  many  points  which 
have  become  fundamental  features  in  this  branch  of 
scientific  research.  Not  that  he  had  already  solved 
problems  which  we  are  still  puzzling  over ;  but  that  he 
obtained  with  what  was  often  remarkable  intuition, 
an  inkling  concerning  them. 

If  I  should  select  a  single  quotation  as  an  example 
of  this,  I  think  it  would  be  the  following : 

Those  things  which  we  do  physically  in  order  to 
exist, — assimilate  and  secrete,  inhale  and  exhale,  we 
must  spiritually  repeat.  A  systole  and  diastole,  an 
exchange  between  expansion  and  contraction  must 
constitute  our  inner  life,  if  it  is  to  remain  sound. 
Just  as  we  keep  on  developing,  learning,  enjoying, 
emerging  out  of  ourselves,  just  so  we  are  forced  into 
ourselves  again  by  the  unbroken  pulse-beat  of  fate, 
and  compelled  to  gather  all  our  powers  at  one  single 
point,  so  that  from  this  point  we  may  again  send 
them  forth  more  widely.  He  who  is  always  elastic  is 
free;  he  who  continually  draws  himself  together, 
petrifies. 

As  I  shall  more  closely  write  out  the  subject  in 
the  following  studies,  all  nervous  ailments  are  con- 
nected in  a  more  or  less  certain  way,  with  the  fact 
that  the  individual's  ability  to  adapt  himself  to  real- 
ity has  been  lost.  Since  this  then  has  two  sides,  an 
outer  and  an  inner,  there  are  two  main  roads  upon 


30        History  and  Practice  of  Psychanalysis 

which  the  individual  departs  from  a  normal  state  of 
life,  and  enters  upon  one  of  disease.  In  connection 
with  this  it  is  possible  to  differentiate  two  fundamen- 
tal types  among  the  sick.  One  consists  of  those  who 
have  lost  connection  with  external  reality.  All  that 
which  takes  place  about  this  type  loses  its  personal 
value.  The  doings  of  humanity  and  its  desires,  are 
only  a  meaningless  jumble,  a  chaotic,  tormenting 
noise;  to  be  dragged  into  this  whirl  would  be,  for 
those  of  this  type,  to  go  under  entirely.  These  peo- 
ple retire  into  themselves.  They  become  reserved 
almost  to  a  state  of  dumbness ;  nobody  comprehends 
them.  Because  of  this  very  fact  they  petrify  more 
and  more,  growing  continually  more  and  more  incom- 
prehensible. Gradually  as  the  emotional  life  loses 
its  plasticity  and  the  feelings  and  impulses  let  go 
their  faculty  of  transformation,  the  actual  restric- 
tive faculty  takes  the  reins  in  hand.  The  individual 
becomes  more  and  more  a  creature  of  habit,  of  com- 
pulsory ideas,  of  hypochondriacal  physical  sensa- 
tions, etc.  The  more  line  is  run  out,  just  so  much 
more  stereotyped  and  automatic  does  life  become. 

The  normal  psychic  life,  to  which  the  formation 
of  an  illness  of  this  sort,  under  unfortunate  circum- 
stances is  attached,  is  founded  in  introspective  na- 
tures, in  contemplative  minds,  in  musers. 

The  other  fundamental  type  consists  of  those  who 
have  lost  connection  with  what  occurs  within  their 
own  minds.  They  know  of  nothing  other  than  the 


Kant  and  Feuchtersleben  81 

world  which  stirs  about  them  and  their  mental  life 
is  only  a  disconnected  reflection  of  all  this  endless 
display  of  forces.  They  are  driven  like  rudderless 
ships  upon  a  sea  of  contending  desires.  Their  lives 
evaporate  in  activity  which  has  no  inner  motive; 
in  purposeless  reactions  against  whatever  occurs 
about  them ;  in  compromises ;  in  every  thinkable  thing 
that  is  unreal.  So  they  grow  farther  and  farther 
away  from  that  inner  centralization  that  alone  can 
give  peace  and  health  of  mind.  If  this  line  of  de- 
velopment is  farther  drawn  out,  the  soul  life  is 
broken  up  into  emotions,  filled  with  anxiety ;  thoughts 
whirl  about  each  other  like  grains  of  sand  before 
the  wind,  and  the  will  which  should  lead  toward  ac- 
tivity with  a  conscious  purpose,  is  exhausted  in  im- 
pulses that  work  against  one  another  and  make  thi 
adoption  of  a  deliberate  aim  impossible. 

The  normal  analogy  to  this  type  is  found  in  those 
shallow,  busy  human-beings,  who  never  give  them- 
selves time  for  contemplation. 

In  the  construction  of  all  outgrowth  of  disease, 
there  is  something  both  of  this  process  of  petrifica- 
tion  and  of  dissolution,  everything  corresponding  to 
changes  in  varying  reciprocal  proportions. 

Feuchtersleben  understood  that  no  one  finds  the 
way  to  true  health  of  mind  unless  he  knows  how  to 
dissolve  these  two  fundamental  parts  into  one  or- 
ganic unity.  In  this  thing  itself,  this  tearing  apart 
of  existence  into  an  inner  and  an  outer  reality,  lies 


32        History  and  Practice  of  Psychanalysis 

the  seed  for  the  building  up  of  disease  in  both  direc- 
tions. 

The  only  possible  way  of  avoiding  this  conse- 
quence is  never  to  lose  contact  with  either  the  outer 
or  the  inner  life,  to  continually  maintain  that  both 
forms  of  life  are  simply  different  sides  of  the  same 
unity  of  occurrence.  "Only  the  spiritually  strong, 
morally  educated  individual  succeeds  in  preserving 
a  certain  inner  quietude,  which  like  the  point  of 
Archimedes,  even  in  troublous  times,  still  constitutes 
a  place  of  retirement  for  the  purpose  of  contempla- 
tion. Here  is  the  true  happiness  of  mankind." 

It  is  this  spiritual  strength  and  culture  in  the 
noblest  meaning  of  the  word,  which  before  everything 
else  must  be  striven  after.  Let  the  storms  of  life  rage 
how  they  will,  let  the  individual  be  involved  in  con- 
flict upon  conflict,  let  him  be  dragged  out  into  the 
mob  which,  with  all  its  commonness,  tries  to  tear  him 
to  pieces  and  kill  every  effort  that  brings  him  life; 
— he  nevertheless  will  be  able  to  maintain  constantly 
a  sacred  depth  within  himself,  whither  he  may  with- 
draw in  quietude  and  where,  with  eyes  unclouded  by 
hate  or  fear,  he  will  be  able  with  calmness  to  take 
note  of  his  surroundings.  Only  in  this  way,  even 
under  the  most  adverse  circumstances,  can  he  main- 
tain his  connection  with  an  inner  reality,  of  which 
he  himself  is  but  a  temporary  appearance ;  only  then 
is  he  proof  against  one  principal  form  of  psychic 
devastation. 


Kant  and  Feuchtersleben  33 

What  every  doctor  most  earnestly  strives  after, 
or  what  should  be  the  aim  in  all  isolating  treatments 
is  just  this,  to  bring  the  patient  away  from  the  whirl 
of  external  life  back  into  inner  reality. 

But  as  strongly  as  Feuchtersleben  points  out  the 
necessity  of  the  contemplative  life,  just  as  strongly 
he  tries  to  direct  the  patient  toward  the  life  of 
activity,  and  he  by  no  means  undervalues  the  impor- 
tance of  this  as  a  means  to  freedom.  "An  able- 
bodied  individual  ought  always  to  have  an  able- 
bodied  work  that  demands  the  co-operation  of  all 
the  forces.  Life  is  only  a  more  or  less  violent  state 
of  tension.  All  relaxation  is  sickness  or  death."  It 
is  just  this  living  connection  with  what  occurs  about 
one,  that  is  of  importance.  Activity  absorbs  energy, 
but  it  also  gives  it.  All  those  impulses  that  it  con- 
stantly carries  with  it,  mean  just  so  many  new  con- 
tributions to  it.  One  with  impaired  energy  can  do 
without  this  still  less  than  can  one  who  is  strong. 
There  is  nothing  that  Feucjhtersleben  so  utterly 
scorns  as  the  hypochondriac,  who  in  his  want  of  will, 
permits  himself  to  be  sucked  down  into  brooding  over 
his  own  condition.  Not  even  in  the  deepest  inner 
calm  must  the  tension  which  during  activity  is  used 
up  in  the  outward  struggle,  be  allowed  to  slip  en- 
tirely. Contemplation  must  always  maintain  a  cer- 
tain stamp  of  innate  activity,  and  only  because  of 
this,  one  runs  no  danger,  even  in  its  most  profound 
moments,  of  gliding  awar  from  that  form  of  reality 


34        History  and  Practice  of  Psychanalysis 

which  is  represented  in  those  happenings  of  the  out- 
side world. 

There  are  people  who  have  fallen  into  such  a  state 
of  inertia  that  they  feel  themselves  incapable  of  thd 
simplest  kind  of  activity.  However  paradoxical  it 
may  seem,  the  only  right  method  of  treatment  is  often 
to  compel  them  to  do  some  work  which  to  them  ap- 
pears impossible,  the  intention  being  to  force  them 
into  that  circulation  of  energy  which  the  external  life 
of  activity  implies.  But  if  this  is  to  succeed  the  work 
must  not  be  without  meaning,  but  must  have  a  deep 
connection  with  those  desires,  because  of  which  the 
individual  may  have  fallen  into  his  state  of  disability. 

I  have  made  these  reflexions  upon  the  foregoing 
citations  from  Feuchtersleben's  work  only  to  show 
how  his  words  by  themselves  give  rise  to  links  of 
associations.  If  these  have  free  development,  they 
soon  reach  out  to  lines  of  thought  and  viewpoints, 
with  which  we  come  into  constant  contact  during 
practice.  In  his  words  lay  seeds  which  subsequently 
have  burst  forth  with  immense  power  for  growth. 
He  should  be  read  slowly;  the  greatest  charm  in 
his  works  is  simply  the  power  of  awakening  thought. 
In  this  way  it  is  profitable  to  stop  to  consider  each 
and  every  sentence. 

I  give  one  more  example. 

In  reading  the  following  lines,  one  sees  the  great 
idea  appearing  for  that  which  now  goes  under  the 


Kant  and  Feuchtersleben  35 

name  of  psychanalysis  and  has  in  this  light,  set  its 
stamp  upon  modern  therapeutics: — 

If  pain  is  coming  upon  you,  or  if  it  has  already 
reached  you,  then  consider  that  you  do  not  annihilate 
it  by  turning  from  it.  Look  it  steadily  in  the  eyes  as 
an  object  for  your  observation,  until  you  clearly 
understand  if  you  ought  to  leave  it  for  what  it  is 
worth,  or  possibly  keep  it  and  use  it.  One  must  first 
become  master  over  an  object  before  he  can  disregard 
it.  That  which  has  in  this  way  been  put  to  one 
side,  constantly  forces  itself  upon  one  with  rigorous 
defiance.  Only  the  real  light  of  day,  by  turning  its 
full  brightness  upon  them,  conquers  the  ghosts  of  the 
night. 

Psychanalysis  is  based  upon  the  fundamental  fact 
that  the  individual  does  not  escape  the  life  he  must 
experience,  by  turning  away  from  it.  On  the  con- 
trary it  is  in  this  way  that  he  really  becomes  a  prey 
to  the  forces  of  life.  For  with  this  effort  to  escape, 
all  the  trouble  sinks  into  the  unconscious,  and  con- 
tinues therefrom  to  bind,  obstruct,  restrain.  What 
makes  this  change  fatal  then,  is  that  in  the  very  mo- 
ment we  lose  conscious  contact  with  what  we  have 
experienced,  we  also  lose  our  power  over  it;  we  are 
hounded  by  anxiety  or  stunned  or  driven  on  towards 
something  we  do  not  desire,  without  even  a  suspicion 
as  to  whence  comes  this  new  enemy  which  haunts, 
paralyzes  and  drives  us  away  from  our  real  selves. 
The  psychoanalyst  shows  how  to  stop  this  flight  and 


36        History  and  Practice  of  Psychanalysis 

look  the  enemy  straight  in  the  eyes ;  he  urges  a  sound- 
ing of  the  depths  through  which  the  past  may  be 
revealed;  he  does  it  because  at  the  same  time,  the 
individual  control  over  the  life-material  expands.  It 
is  primarily  in  the  strength  of  inner  masterfulness 
that  we  can  be  successful  in  throwing  off  suffering,  or 
in  changing  the  values  of  life  into  others  of  standard 
worth.  In  all  this  I  come  back  to  the  study  of 
psychanalysis  once  more ;  one  might  say  that  this  in 
its  entirety  is  an  exposition  of  the  theme  which  is 
advanced  in  these  quotations  from  Feuchtersleben. 

But  Feuchtersleben  was  not  only  a  thinker,  he  was 
also  a  poet. 

And  it  is  in  many  respects  an  interesting  and  im- 
portant fact,  that  psychotherapeutics  had  one  of 
its  deepest  fundamental  roots  in  the  mind  of  a  poet. 

In  the  idea  of  a  firm  directing  of  the  attention, 
which  has  several  times  been  spoken  of,  there  is  al- 
ready found  an  indication  of  productivity  from  the 
inner  life.  For  through  this  a  human  being  ceases 
to  be  simply  the  outcome  of  a  series  of  external 
forces.  There  is  put  into  motion  something  which 
has  its  central  point  within  himself  and  which  is 
anticipated  by  his  existence  as  an  independent  being. 
The  poet  can  never  be  a  determinist.  The  moment 
an  individual  loses  the  feeling  of  being  the  ultimate 
conception  for  some  work  of  creation  which  can 
not  go  on  without  him,  that  moment  he  ceases  to  be 
a  poet.  It  is  easy  then  to  see  the  close  connection 


Kant  and  Feuchtersleben  37 

between  poetry  and  psychotherapy.  One  might  also 
say  in  the  same  connection:  in  that  same  moment, 
the  individual  also  ceased  to  be  well.  The  feeling  of 
happiness,  courage,  confidence,  hope, every- 
thing that  must  be  found  in  the  healthy  psychic  life 
is  so  closely  bound  up  with  the  certain  knowledge 
that  creation  is  going  on  within,  that  the  two  things 
cannot  really  be  separated. 

Feuchtersleben  understood  this  as  only  the  born 
poet  can  understand  it.  And  he  understood  in  con- 
nection with  it,  how  needful  it  is,  that  the  psycho- 
therapist should  direct  the  patient  towards  this  idea 
of  creating, — towards  a  positive  goal. 

He  writes: — 

Only  by  putting  something  in  the  place  of  some- 
thing else,  does  the  former  really  become  negative — 
a  law  which  not  only  for  the  dietitian  of  the  soul,  but 
for  all  phases  of  life  has  most  weighty  consequences. 
Everything  that  is  shallow,  bad,  false  and  ugly,  will 
be  actually  denied,  only  when  in  its  stead  it  put  what 
is  noble,  good,  true  and  beautiful.  He  who  considers 
all  these  evils  as  something  real  and  struggles  against 
them,  is  lost.  They  must  be  treated  as  if  they  were 
nothing. 

Only  that  which  plays  a  role  in  the  creating  part 
of  the  upbuilding  of  human  life  is  real.  Because  of 
this  then  the  specific  qualities  of  the  poet  are  more 
essential  for  the  development  of  health  than  are 


38        History  and  Practice  of  Psychanalysis 

those  of  the  logician.  "Knowledge  does  not  have  the 
power  of  instilling  us  with  participation  in  life. 
Rather  does  it  exhibit  it  to  us  in  its  nothingness. 
It  is  fantasy  and  feeling  which  awaken  our  interest 
in  its  fleeting  appearances  and  through  these  give 
us  happiness.  Thus  art  is  a  more  health-giving  aim 
than  philosophy."  All  the  intimate  connection  be- 
tween these  things  really  lies  in  this  sentence :  "Keep 
yourself  in  contact  with  that  which  is  beautiful. 
From  the  beautiful  arises  that  which  is  good  in  man- 
kind,— even  health  itself." 

In  order  that  the  inner  power  of  creation  may  be 
realized,  there  exists  a  demand  that  tendencies  in 
this  direction  should  not  be  met  with  unconquerable 
opposition.  The  awakening,  releasing  stream  of 
thought  and  feeling  must  meet  a  certain  plasticity 
of  soul,  due  to  which,  that  which  already  has  exist- 
ence becomes  transformed  and  valued  anew.  If  the 
inner  life  is  petrified  by  lines  of  thought  that  have 
become  habitual  and  if  the  feelings  are  undisturbedly 
fixed  upon  definite  things  and  into  definite  forms, 
there  is  nothing  to  be  done.  If  each  new  truth  and 
every  deepened  understanding  meets  with  that  kind 
of  skepticism  which  gives  itself  out  to  be  ripe  su- 
periority, but  which  at  closer  range  discloses  itself 
as  spiritual  death,  then  the  aim  of  the  psychoanalyst 
becomes  a  vain  one.  It  is  the  poet's  privilege,  more 
than  that  of  any  other,  to  maintain  this  mobility  of 
soul.  Each  true  poetical  work  contains  a  regenera- 


Kant  and  Feuchtersleben  89 

tion,  without  which  the  work  would  be  impossible  to 
achieve, — its  value  for  others  is  accounted  in  the 
same  degree  in  which  it  implies  something  for  them 
which  it  implied  for  the  author.  Psychotherapy 
must  be  considered  as  a  form  of  poetry  in  which 
one  is  made  free  from  all  external  technical  methods, 
which  otherwise  act  as  intermediaries  between  that 
which  happens  within  the  poet  and  that  which  hap- 
pens within  those  who  follow  him. 

While  speaking  of  Kant  I  pointed  out  the  impor- 
tance of  his  having  reached  knowledge  of  the  simplest 
basic  facts  of  psychotherapy,  through  self-observa- 
tion; only  in  that  way  could  it  have  been  stamped 
with  an  unshakable  surety.  Something  like  this  is 
always  the  case,  when  psychotherapy  rises  from  its 
simplest,  to  its  most  complicated  analytical-creating 
forms.  In  Kant's  case,  self-observation  concerned 
sensations  which  followed  a  partly  physical  disturb- 
ance. With  his  successors  who  must  more  and  more 
be  drawn  toward  psychic  suffering,  this  has  dealt 
rather  with  the  critical  examination  of  what  happens 
within  the  individual  when  the  balances  of  life  be- 
come disturbed.  It  is  a  common  saying  among 
psychoanalysts :  no  one  can  go  farther  in  the  analy- 
sis of  another  than  he  has  gone  in  the  analysis  of  him- 
self. But  the  following  correlation  may  be  ap- 
pended without  hesitation;  no  one  can  go  farther 
toward  the  redemption  of  another  than  he  has  gone 


40        History  and  Practice  of  Psychanalysis 

toward  the  redemption  of  himself.  It  is  not  enough 
for  self-observation  to  pay  attention  only  to  the 
blasting  of  destructive  powers:  it  must  also  and 
above  all  follow  those  lines  upon  which  these  are  to 
be  conquered  and  upon  which  one  succeeds  in  making 
life  worth  living. 

It  is  this  idea  which  is  the  ultimate  reason  for 
that  surety  with  which  the  psychotherapist  defends 
his  ground  against  all  attacks.  It  is  also  this  which 
makes  this  branch  of  therapeutics  remain  for  so 
many  a  kind  of  mystery  and  which  is  the  reason  why 
attacks  against  it  are,  as  a  rule,  stamped  with  a 
kind  of  stupidity,  before  which  refutation  seems  of 
little  use.  Where  inner  qualifications  for  the  under- 
standing of  such  a  conception  are  lacking,  surely  no 
description  can  make  clear  what  it  really  means. 
One  whose  psychic  life  has  been  submerged  in  purely 
mechanical  processes  and  who  has  thus  changed  into 
a  conglomerate  of  automatic  functional  complexes, 
can  scarcely  acquire  a  comprehension  of  that  process 
of  inner  emancipation,  about  which  the  whole  science 
of  psychanalysis  revolves.  For  such  a  one  all  this 
remains  the  same  meaningless  nonsense,  which  higher 
mathematics  means  to  one  who  has  been  unable  to 
teach  himself  to  add. 

But  although  psychotherapy  is  in  this  way  finally 
an  inner  experience,  it  is  obvious  that  it  is  not  that 
alone.  It  must  also,  as  a  foundation,  have  an  ex- 


Kant  and  Feuchtersleben  41 

ternai  point  of  contact  upon  which  medical  science 
comes  in  as  one  of  the  many  ingredients. 

I  come  again  to  that  circumstance  upon  which  I 
wished  to  fix  attention  in  this  paper,  namely,  the 
deep  import  of  the  fact  that  the  foremost  thinker 
in  history  and  one  of  its  most  renowned  poets  had 
a  hand  in  the  bringing  to  light  of  this  branch  of 
science. 

It  is  the  philosopher's  task  to  draw  out  personal 
experiences  into  universal  knowledge  and  in  this 
way  to  find  the  connection  between  that  which  hap- 
pens within  and  without  us.  One  who  has  nothing 
of  this  philosophical  spirit  remains  always  shut 
within  himself  believing  only  that  that  which  means 
good  to  him  means  good  to  others.  But  for  no  one 
is  it  so  important  as  for  the  psychotherapist,  to 
keep  wide-open  eyes  for  the  finest  nuances  of  indi- 
viduality. He  must  himself  be  able  to  live  in  that 
which  occurs  in  the  psychic  life  of  others,  no  mat- 
ter how  different  it  may  be  from  that  which  happens 
within  his  own. 

But  this  intimate  connection  with  something  for- 
eign can  never  take  place  alone  through  knowledge 
and  analysis.  It  needs  besides  this,  something  else, 
it  needs  a  faculty  for  instinctively  feeling  a  way 
into  that  which  is  not  altogether  comprehensible 
by  thought.  The  real  poet  reacts  with  his  over- 
sensitivity  to  everything  that  comes  in  his  way; — 


48        History  and  Practice  of  Psychanalysis 

with  no  fixed  boundaries  he  lets  himself  float  out 
into  the  world  about  him  and  identifies  himself  with 
whatever  goes  on  there. 

Without  something  of  this  faculty  of  the  poet  for 
taking  part,  with  the  whole  of  his  personality,  in 
all  that  lives  and  suffers — without  this,  no  one  is 
likely  to  spread  a  blessing  upon  the  path  of  psycho- 
therapy. 


n 


WETTERSTKAND    AND   THE   NANCY   SCHOOL 

IN  front  of  me  lie  some  of  Wetterstrand's  letters 
written  to  various  members  of  his  family.  They 
are  yellow  with  age.  I  have  selected  one,  dated  from 
Uppsala,  September  5th,  1866.  He  was  then  twen- 
ty-one years  old  and  had  been  a  medical  student 
for  four  years.  The  letter  was  written  to  a  younger 
brother : — 

.  .  .  Through  a  letter  from  father  I  have  heard 
that  you  would  like  to  change  your  determination 
about  becoming  vitae  genus.  Without  wishing  in  any 
sense  to  impose  anything  upon  you  or  your  opinions, 
for  in  such  matters  as  this  you  are,  and  should  be, 
entirely  alone  regarding  your  decision,  still  I  wish 
to  say  a  few  words  to  you,  before  you  heedlessly 
start  in  upon  a  new  track  which  is  doubtless  as  yet 
quite  unexplored  by  you.  The  profession  of  medi- 
cine is  inexpressibly  laborious,  both  during  the  period 
of  preparation  and  throughout  the  whole  life  of 
practice.  He  who  chooses  this  profession  should 
first  consider  well.  He  has  dedicated  the  whole  of 
his  life,  every  minute  of  it,  to  the  struggle  against 
human  suffering  in  all  of  its  forms,  he  has  conse- 

43 


44«        History  and  Practice  of  Psychanalysis 

crated  himself  to  an  unceasing  contemplation  of  la- 
mentation, misery  and  death.  Not  only  during  the 
day,  but  during  the  night  as  well,  must  his  work 
go  on.  In  hospitals,  in  every  kind  of  emergency,  in 
pest-houses,  the  material  for  the  building  of  his  life 
is  gathered  together.  If  he  desires — and  that  he 
must  do, — to  advance  in  science,  he  must  study  in- 
cessantly. He  has  no  moment  to  himself.  If  he 
sometimes  thinks:  this  hour  is  mine,  he  thinks  what 
is  not  true ;  the  time  does  not  belong  to  himself,  but 
to  those  who  are  in  distress  and  suffering.  The 
practice  of  this  profession  demands  almost  super- 
human power.  The  physician  must  stand  ready  for 
everything  and  everybody.  A  constant  danger 
threatens  him,  the  sword  of  Damocles  hangs  con- 
tinually over  his  head ;  I  mean  Death,  the  inevitable, 
with  which  he  is  always  in  contact.  If  one  takes  into 
consideration  the  years  of  preparation,  those  of  the 
medical  student  are  quite  different  from  those  of 
students  in  other  fields.  In  the  anatomy  class,  in 
the  midst  of  decomposing,  mutilated  bodies,  he  has 
opportunities  to  think  over  the  passing  of  life  and 
the  certainty  of  death.  It  is  true  that  scientific  de- 
sires are  here  appeased  with  knowledge  concerning 
the  wonders  of  the  construction  of  the  human  or- 
ganism and  explanation  of  the  mystery  of  the  phe- 
nomena of  life.  But  how  is  this  insight  reached  ?  By 
means  of  mutilation  of  bodies  like  our  own  and  by 
the  dissection  of  living  animals.  This  is  the  only 
path  upon  which  the  student  of  medicine  may  tread. 
I  myself  have  experienced  inexpressible  things.  The 
knife  trembled  in  my  hand  when  I  made  my  first  in- 
cision into  a  cadavar;  how  must  it  then  be  to  use  it 
upon  a  living  subject?  The  loathsome  smell  of  the 


Wetterstrand  and  the  Nancy  School        45 

autopsy  room,  the  ever  constant  danger  of  being 
poisoned  in  the  laboratory,  still  pursue  me.  The 
state  of  mental  tension,  in  which  one  must  contin- 
ually live,  is  impossible  to  describe. 


It  would  be  difficult  to  find  a  document  that  more 
plainly  expresses  the  sensation  of  horror,  which  must 
present  itself  to  every  earnest  young  man,  when  the 
import  of  a  doctor's  life  is  put  before  him.  The 
banal  student  puts  aside  this  feeling  as  one  of 
pure  sentimentality  and  within  a  few  days  the  whole 
thing  becomes  for  him  a  profession,  which  moves 
him  as  little  as  any  other.  Death  itself,  for  the  most 
of  such  students,  would  become  a  matter  of  pure  in- 
difference, unless  they  were  obliged  to  learn  that 
they  must  not  come  unnecessarily  into  contact  with 
it;  otherwise  their  future  reputation  as  its  master 
would  be  in  jeopardy.  How  often  I  have  seen  hos- 
pital students  examining  the  dying  with  the  same  un- 
concern as  if  it  were  a  question  of  putting  a  worn- 
out  machine  into  repair!  But  the  true  physician 
never  loses  his  sensitiveness  for  suffering  and  for 
him  life  never  ceases  to  be  a  bitter  combat  with  death. 
Just  as  the  artist  is  over-sensitive  to  certain  groups 
of  impressions  that  continually  stream  over  us  all, — 
color,  form,  moods,  conflicts, — so  is  the  born  physi- 
cian over-sensitive  to  suffering.  Out  of  this  super- 
sensitiveness  the  intuitive  "doctor's  eye"  proceeds. 
As  a  musician  trembles  in  response  to  some  tone 


46        History  and  Practice  of  Psychanalysis 

which  passes  by  the  unmusical  ear  as  an  indifferent 
sound,  so  the  born  physician  perceives  a  physical  or 
psychical  dissonance,  which  the  busy  external  life 
hides  from  others.  Because  of  this  faculty,  suffer- 
ing becomes  so  intimately  connected  with  his  own 
life  that  he  really  can  make  himself  free  from  it 
just  as  little  as  he  can  separate  himself  from  his 
own  personality.  Neither  can  he  ever  resign  himself 
to  suffering.  He  must  make  a  struggle  against  it 
even  if  the  effort  seems  a  hopeless  one.  He  must 
try  to  master  it — or  go  under  in  the  attempt.  Or 
more  aptly  expressed  he  must  dedicate  his  life  to  the 
removal  of  some  small  part  of  the  most  grievous  dif- 
ficulties that  lie  in  the  path  of  humanity  and  turn 
it  toward  the  fulfillment  of  a  more  harmonious  exist- 
ence. 

In  looking  back  upon  Wetterstrand's  life,  now 
since  his  death,  the  letter  quoted  seems  full  of  a 
kind  of  fatality.  ...  It  is  certain  that  he  himself 
never  had  the  feeling :  "this  hour  belongs  to  me,  now 
I  shall  enjoy  it  as  if  no  trouble  in  the  world  were 
any  concern  of  mine."  During  that  period  when  he 
was  at  the  height  of  his  activity,  he  scarcely  took 
time  for  sleep;  from  half-past  five  in  the  morning 
until  far  into  the  night,  it  was  his  one  continual 
effort  to  reach  a  true  understanding  of  his  patients. 
This  broke  him  down  in  ten  years'  time  and  he  took 
up  his  own  long  struggle  against  death  which  after 
ten  years  more  finally  conquered  him.  But  up  to  the 


Wetterstrand  and  the  Nancy  School        47 

last  he  tried  to  keep  up  his  practice.  Even  when  he 
was  so  weak  that  he  could  have  died  at  any  time 
he  forced  himself  up  and  out  among  his  sick — he 
was  simply  unable  to  let  go  that  hold  he  had  upon 
suffering  and  for  the  assurance  of  which  he  had  given 
his  own  life  as  security. 

But  with  Wetterstrand  there  was  also  quite  an- 
other feature  than  this  over-sensitiveness  for  suffer- 
ing, this  compulsion  to  connect  himself  with  it,  this 
will  to  struggle  against  everything  that  is  destruc- 
tive to  life.  He  was  gentle  in  his  manner  and  there 
was  something  strangely  quiet  and  harmonious  about 
his  own  personality.  Even  more  than  for  suffer- 
ing was  he  sensitive  to  every  living,  producing,  re- 
generating force  in  nature  and  in  humanity.  This 
shows  itself  continually  in  the  letters  I  have  before 
me.  Most  of  them  are  written  from  Vienna,  whither 
he  betook  himself  after  his  final  examinations,  for 
the  purpose  of  improving  his  knowledge  in  diseases 
of  the  eye  and  in  surgery.  Among  his  descriptions 
of  hospitals  and  operating-rooms,  one  finds  him 
dilating  upon  the  scenery  and  the  works  of  art  which 
especially  fascinated  him.  It  is  as  if  the  yearning 
of  a  lifetime  brimming  over  in  his  soul,  suddenly 
broke  bonds,  in  spite  of  everything  that  sought  to 
convince  him  that  existence  is  nothing  but  a  wilder- 
ness of  desolation.  I  read  for  example,  the  follow- 
ing reflexion: — 

So  well  may  the  works  of  poets  and  artists  be  com- 


48        History  and  Practice  of  PsycTianalysis 

pared  with  the  stained  glass  in  these  Catholic 
churches.  Looked  at  from  without  everything  seems 
dark  and  dismal!  But  only  go  inside  and  all  takes 
on  another  aspect ;  the  glass  gives  out  all  the  colors 
of  the  rainbow  and  if  one  has  a  little  imagination, 
one  soon  sees  the  pictures  come  to  life.  It  is  the 
same  way  with  poetry.  It  may  be  written  with  the 
pen,  painted  with  the  brush  or  hewn  out  of  stone, 
but  it  must  not  be  looked  upon  from  without  nor 
with  prosaic  eyes.  It  is  because  it  has  been  so  looked 
upon  that  so  many  have  never  understood  poetry  or, 
upon  the  whole,  disdain  all  poetical  points  of  view. 

Wetterstrand  felt  this  strong  necessity  of  seeing 
life  from  within.  The  dreadful  things  he  had  to  ex- 
perience as  a  physician  never  became  all  that  nature 
had  to  tell  him  about  human  existence.  There 
must  be  some  sanctuary  wherein  even  the  most  cheer- 
less and  meaningless  things  change  and  acquire 
their  inner  connection.  He  who  reaches  this  shrine 
has  overcome  suffering  by  another  path  than  that 
upon  which  the  usual  system  of  therapeutics  has 
made  its  struggle  on  through  centuries.  For  at  the 
same  time  when  there  comes  a  glimmer  of  poetry, — 
of  re-birth — over  that  which  looked  at  from  without 
has  seemed  the  absolute  negation  of  life,  at  the  same 
time  redemption  is  drawing  nigh.  Wetterstrand  had 
a  strong  feeling  for  this  eternal  pouring  out  of  life 
from  within,  from  mysterious  depths  which  we  never 
quite  can  fathom.  From  this  feeling  arose  in  him 
appreciation  of  the  faculty  of  seeing  all  things  with 


Wetterstrand  and  the  Nancy  School        49 

the  poet's  eye,  which  may  be  observed  in  this  quota- 
tion from  his  letter.  This  feeling  was  also  the  basis 
for  his  strong  belief  in  the  possibility  of  overcoming 
disease  through  some  psychic  means.  No  theoretical 
controversy,  no  attack,  no  discouraging  experiences 
could  disturb  this  belief; — in  it  lay  his  strength. 
But  in  it  lay  also  his  limitations. 

The  work  of  the  practical  physician  contains 
however  little  enough  of  poetry,  no  matter  if  in  the 
depth  of  his  soul  he  may  have  never  so  poetical  an 
outlook  upon  the  world.  When  Wetterstrand  came 
home  from  his  journey,  a  position  as  district  physi- 
cian to  the  poor  awaited  him,  and  there  he  came 
into  touch  with  plenty  of  life's  prose.  "I  begin  the 
day  with  looking  at  tongues  and  curing  cases  of 
diarrhea,"  he  writes  in  one  of  his  following  letters. 
And  he  continued  for  fifteen  years  to  fulfill  all  the 
dismal  duties  attached  to  this  office. 

Sometime  about  1885,  Liebeault's  work  entitled 
"Le  Sommeil  provoque  et  les  etats  analogues,"  fell 
into  the  hands  of  Wetterstrand.  Predestined  as  he 
was  by  the  whole  tendency  of  his  nature  for  the 
psychic  side  of  disease,  nothing  more  was  needed 
to  cause  a  complete  change  in  his  work.  He  had  in- 
tended to  become  a  specialist  in  diseases  of  the  lungs. 
But  now  he  discovered  that  he  must  start  out  in 
quite  a  different  direction. 

However  much  modern  medical  research  may  work 
towards  the  reduction  of  the  cause  of  disease  to  solely 


60       History  and  Practice  of  P&ychanalysis 

extraneous  physical  facts,  it  does  not  succeed  in 
rooting  out  of  the  folk-consciousness  the  conception, 
that  these  causes  have  in  their  finality  something  to 
do  with  the  conflicts  of  life.  People  may  have  all 
possible  respect  for  the  bacillus  of  tuberculosis  and 
know  what  mischief  it  produces;  but  they  neverthe- 
less never  cease  to  exclaim:  "He  worried  himself 
into  consumption."  If  one  starts  to  investigate  this 
postulated  connection  between  life  and  suffering,  a 
group  of  disturbances  that  are  called  functional,  are 
first  met  with.  Conflict  alone  can  bring  only  the 
functions  of  an  organ  into  a  disturbed  condition.  It 
can  not  directly  destroy  its  tissues.  To  what  degree 
it  in  time  may  act  injuriously,  so  that  the  organ  or 
organism  becomes  easier  prey  for  further  injuries, 
is  a  question  which  just  now  may  be  put  aside.  Tra- 
ditional medical  science  has  a  great  inclination  to 
overlook  the  importance  of  functional  diseases.  Even 
today  there  are  physicians  who  satisfy  themselves 
with  the  phrase :  "Only  hysteria !"  if  after  physical 
examination  they  can  find  nothing  upon  which  to 
take  certain  hold.  And  against  this  kind  of  suffer- 
ing they  have  the  most  illusory  expedients  to  recom- 
mend. Unfortunately  the  patient  can  scarcely  make 
such  a  bagatelle  of  his  suffering  as  can  the  doctor; 
for  him  the  word  "only"  is  small  comfort  and  his 
pain  is  as  hard  to  bear  as  any  physical  disease. 

Many  times  I  have  had  patients  say  to  me :   "If  I 
had  cancer  and  so  some  hope  of  death !    But  to  live 


Wetter  sir  and  and  the  Nancy  School        51 

on  year  after  year  like  this,  it  is  more  than  I  can 
endure."  I  recall  a  young  man  who  came  to  me 
suffering  from  nervous  incontinence,  and  who,  as  a 
matter  of  little  importance  in  comparison,  told  me 
that  he  also  had  pulmonary  tuberculosis.  "As  for 
that,"  he  said,  "I  care  very  little  about  it;  either  I 
shall  get  well  of  it  or  die  and  we  shall  all  die  some- 
time. But  it  is  a  thousand  times  worse  with  the 
other  thing.  That  makes  pretty  much  every  hour 
one  of  torment,  so  that  I  have  not  the  slightest  com- 
fort in  life!"  And  it  is  true:  in  the  face  of  death 
the  healthy  individual  can  be  resigned  far  easier  than 
before  a  kind  of  suffering  which  makes  the  short  time 
we  at  best  have  to  live,  of  no  value. 

The  physician  who  is  inspired  by  a  genuine  feeling 
for  his  calling,  cannot  pass  by  these  functional 
diseases  with  such  indifference.  And  if  he  has  dif- 
ficulty in  resigning  himself  to  the  limitations  of  the 
science  of  medicine,  its  powerlessness  in  this  sphere  is 
to  him  a  constant  source  of  worry.  And  if  there  is 
in  him  a  blending  of  warm  feeling  for  the  pathos  of 
life  and  of  that  over-sensitiveness  for  suffering  which 
was  so  marked  in  Wetterstrand,  this  kind  of  disease 
and  the  fight  against  it  must  be  for  him  something 
of  the  highest  importance. 

As  for  so  many  others,  Li£beault  was  a  kind  of 
evangelist  for  Wetterstrand.  His  work  awakened 
hope  of  a  possibility  of  rational  attack  against  func- 
tional disease.  And  the  way  he  pointed  out  was 


52        History  and  Practice  of  Psychanalyns 

free  from  all  that  repellent  mystery  in  which  earlier 
attempts  had  been  enveloped.  Without  danger  of 
losing  its  dignity,  science  might  take  its  stand  upon 
this  path.  Its  fundamental  experiments  could  be 
again  produced,  their  application  to  the  art  of 
treatment  could  be  worked  out  and  systematized. 

Wetterstrand  did  not  hesitate  to  put  these  new 
ideas  to  practical  proof.  It  was  at  that  time  a 
fortunate  circumstance  perhaps,  that  he  already  had 
a  large  clientele  which  hitherto  he  had  treated  ac- 
cording to  the  usual  methods  and  which  had  un- 
bounded confidence  in  him.  It  was  quite  plain  that 
these  patients  were  most  fertile  soil  for  treatment  by 
suggestion.  The  rumor  spread  that  wonderful  things 
happened  in  Wetterstrand's  consulting-room.  Those 
unfortunates  who  formerly  had  gone  away  unbene- 
fitted,  returned  in  the  hope  that  the  hour  of  freedom 
at  last  had  struck. 

There  is  certainly  no  demand  so  deeply  rooted  in 
the  mass  of  humanity  as  the  demand  for  wonders; 
indeed  is  there  anyone  who  can  fully  give  up  a  hope 
that  the  world-regulation  so  much  needed,  may  some 
time  be  accomplished,  by  a  revelation  which  will  solve 
all,  explain  all? 

Here  it  was  as  if  a  new  Bethesda  suddenly  had 
arisen.  The  news  spread  throughout  the  town.  A 
stream  of  sick  people  came  from  all  directions.  The 
consultation-room  was  besieged.  People  sat  outside 
on  the  stairs  and  waited.  It  was  no  question  of  dif- 


Wetterstrand  and  the  Nancy  School        53 

ferentiation  between  functional  and  organic  disease, 
between  what  could  be  attacked  by  this  new  method 
and  what  was  inaccessible  to  it.  Delighted  over  the 
possibilities  that  opened  before  him,  Wetterstrand 
himself  did  not  define  so  closely  as  he  should  have 
done,  in  order  to  preserve  the  reputation  of  his 
method  of  treatment.  He  seemed  to  believe  that 
through  suggestion,  both  tumors  and  broken  legs 
could  be  cured.  Only  by  slow  degrees  did  he  learn 
to  place  the  right  indications. 

Surely  during  this  early  time  he  had  most  sur- 
prising results.  I  have  often  heard  from  entirely  re- 
liable people,  case-histories  related,  which  I  could  not 
have  believed  had  they  reached  me  in  any  other  way. 
Judging  from  all  points  of  view  it  seems  to  me  that 
no  one  has  ever  succeeded  in  reaching  the  results  he 
reached  in  treatment  by  suggestion.  Physicians  of 
a  skeptical  type  may  shrug  their  shoulders  at  this 
and  talk  of  a  psychic  epidemic.  A  scornful  word 
nevertheless  cannot  overthrow  what  is  an  absolute 
matter  of  fact.  And  the  reply  to  such  objections 
appears  to  me  self-evident: — in  like  conditions, 
physicians,  with  all  their  might,  should  seek  the  con- 
tinuation of  such  an  epidemic.  An  epidemic  that 
frees  masses  of  people  from  suffering,  before  un- 
available for  treatment,  must  surely  be  considered  as 
something  inexpressibly  good,  as  well  for  the  physi- 
cian as  for  the  community. 

This  new  work  forced  Wetterstrand  to  leave  his 


54        History  and  Practice  of  Psychanalysis 

position  as  district  doctor.  He  moved  from  his  for- 
mer home  to  a  place  more  suitable  to  his  special 
needs.  Here,  during  a  period  of  ten  years  (1887- 
1897),  was  carried  on  that  practice  which  seems 
to  me  to  be  one  of  the  most  interesting  in  medical 
history. 

Wetterst  rand's  reputation  during  this  time  spread 
farther  and  farther.  It  was  not  restricted  to  his  own 
country  nor  to  Europe  itself.  His  name  became 
the  foremost  in  the  cosmopolitan  neurotic  clientele. 
Many  doctors  came  from  abroad  to  study  this  new 
branch  of  therapeutics. 

Wetterstrand  did  not  win  his  reputation  through 
the  writings  he  gave  out  during  this  period.  This 
part  of  his  work  had  relatively  slight  importance  by 
the  side  of  his  practical  work.  His  fame  spread  from 
patient  to  patient.  With  the  same  inclination  no- 
toriety has  for  magnifying  faults  when  propagated 
by  the  evil  minded,  with  just  the  same  ease  is  mag- 
nified every  good  thing  when  spread  abroad  by  those 
who  are  thankful  and  well  disposed.  From  the  press 
also  came  more  or  less  embellished  stories — a  thing 
that  has  little  that  is  agreeable  in  it  for  a  scientific 
worker,  but  which  more  than  anything  else  con- 
tributes toward  giving  the  wonder-worker  a  brighter 
nimbus. 

Such  a  description  of  Wetterstrand's  work  came 
out  in  a  book  by  Ludvig  Hevesi,  under  the  title: 


Wettentrand  cmd  the  Nancy  School        55 

"The  Grotto   of   Sleep."     He  writes   among  other 
things : 

Wetterstrand's  house  differs  in  no  way  from  other 
houses  which  stand  in  the  beautiful  quarter  of  the 
town  under  the  shadow  of  the  Royal  Library.  But 
in  the  second  story  are  two  large  rooms  in  which 
lives  a  wondrous,  unbelievable  modern  wizard.  Daily 
from  nine  until  four  o'clock,  remarkable  magic  goes 
on,  while  from  sixty  to  seventy  people  a  day  are 
amazed  and  would  not  credit  the  thing  if  they  them- 
selves had  not  played  a  part  in  it.  Silently  one 
enters  the  place,  for  heavy  reddish-brown  rugs  cover 
the  floor.  A  faint  light  fills  the  rooms — no  clocks 
tick,  no  flies  buzz,  no  doors  creak.  The  furniture 
consists  only  of  lounges,  sofas,  divans  and  arm 
chairs.  Upon  each  of  these  is  lying  or  sitting  a 
motionless  figure,  a  petrified  man,  a  rigid  woman 
or  a  child.  No  one  of  them  moves  a  muscle.  There 
is  no  snoring,  no  moaning,  as  in  ordinary  sleep. 
But  they  really  sleep.  They  sleep  as  calmly  and  in- 
nocently as  a  child  at  its  mother's  breast.  A  faint 
smile  spreads  itself  over  every  face.  The  harmony 
of  unconsciousness  flows  over  these  fortunate  ones. 
Is  it  an  opium  dive  where  one  smokes  oneself  into 
insensibility?  One's  eyes  seek  the  door-posts  to  see 
if  they  are  of  ivory,  as  in  the  dream  land  of  Homer. 
The  Silence  of  Death .  .  . 

Wetterstrand's  reputation  as  a  worker  of  won- 
ders has  seldom  stood  so  clear  before  me  as  when 
I  once  after  his  death  read  a  letter  addressed  to  him 


56        History  and  Practice  of  Psychanalysis 

which  was  sent  to  me  to  be  answered.  It  was  from  a 
man  in  New  York.  He  was  well  himself,  but  he  had  a 
wife  who  was  peculiarly  fractious;  when  the  storms 
of  temper  came  upon  her  she  grew  so  violent  that 
she  beat  both  husband  and  children.  Unfortunately 
the  letter-writer  was  unable  to  send  her  away  for 
treatment.  But  he  wished  to  inquire  if  Dr.  Wet- 
terstrand  could  not  teach  him  a  method  by  which  he 
could  quickly  hypnotize  her  whenever  the  necessity 
arose,  so  that  in  this  way  he  might  have  peace  in  his 
house. 

What  took  place  at  this  time  in  Wetterstrand's 
house  was  only  one  part  of  the  movement  that  had 
its  origin  in  Liebeault.  A  few  words  concerning  the 
historical  qualifications  of  this  movement  may  pos- 
sibly be  of  interest. 

It  is,  upon  several  points,  united  with  animal 
magnetism.  After  this  idea  lost  its  energy,  the 
recollection  of  it  still  lived  among  a  few  investigators, 
and  magnetisers  continued  to  make  an  effort  toward 
the  revival  of  the  study  through  so-called  psychic 
performances.  One  of  these  so-called  magnetisers 
visited  Manchester  about  the  year  1870.  One  even- 
ing the  well  known  surgeon  Braid,  happened  to  be  in 
the  audience.  He  was  convinced  that  these  so-called 
magnetic  phenomena  were  no  humbug ;  something  was 
hidden  behind,  but  something  quite  other  than  the 
action  of  a  hypnotic  fluid.  He  began  to  make  experi- 
ments and  found  that  he  could  put  a  number  of  dif- 


Wetterstrand  and  the  Nancy  School        57 

ferent  individuals  into  a  peculiar  condition,  by  com- 
pelling them  to  fix  the  eyes,  and  in  this  way  the 
attention  also,  upon  a  given  point.  This  condition 
he  first  called  "nervous  sleep"  and  his  book  upon  the 
subject  was  given  the  title  "Neurhypnology" ;  from 
this  the  word  hypnotism,  later  on,  arose.  In  the  writ- 
ten description  of  this  condition,  characteristics  of 
magnetic  sleep  again  came  up ;  especially  he  pointed 
out  how  a  great  many  different  kinds  of  nervous 
disturbances  disappeared  during  this  sleep,  as  if  by 
witchcraft. 

Regarding  the  genesis  of  this  condition  he  had,  at 
first  some  physiological  ideas.  But  his  town  was  vis- 
ited also  by  an  "electro-biologist"  and  the  thoughts 
brought  to  him  in  this  way,  led  him  upon  another 
track. 

The  phenomena  by  which  this  "electro-biologist" 
entertained  the  public,  in  these  days  would  be  called 
something  more  akin  to  suggestion  in  the  waking 
state. 

The  performance  which  they  gave  was  one  in 
which  members  of  the  audience  were  permitted  to 
come  up  upon  the  stage,  and  then  false  ideas  were 
presented  to  and  accepted  by  them.  In  this  way  peo- 
ple were  induced  to  mistake  potatoes  for  apples,  to  be 
terrified  by  animals  which  were  not  there,  etc.  Braid 
took  up  the  study  of  this  phenomena  and  began 
to  look  upon  his  hypnotic  experiments  from  a  more 
psychological  point  of  view.  From  the  literature 


58       History  and  Practice  of  Psyclianalysis 

that  I  have  been  able  to  obtain  concerning  this,  I 
am  not  fully  clear  how  far  he  was  able  to  go;  it 
seems  to  me,  however,  that  he  became  entangled  in  a 
great  many  contradictions  which  came  up  in  the 
course  of  his  work.  When  Bramwell  brought  the  dis- 
cussion of  the  Nancy  School  into  London  medical 
circles,  he  made  an  effort  to  claim  that  Braid  had 
really  anticipated  the  whole  thing.  In  this  there  is, 
without  doubt,  exaggeration.  It  is  certain,  however, 
that  Braid  did  not  succeed  in  making  the  phenomena 
of  suggestion  a  matter  of  general  study. 

Most  of  his  work  was  submerged  in  the  opposi- 
tion of  traditional  medicine.  On  the  other  hand  it  is 
perhaps  true,  that  the  chief  importance  of  the  work 
of  the  Nancy  School  lies  in  the  fact  that,  to  a  cer- 
tain degree,  it  was  successful  in  breaking  through 
this  opposition. 

If  Liebeault  had  continued  his  work  alone,  he 
would  surely  have  i>een  just  as  unfortunate  as  Braid 
and  others  of  his  predecessors.  Liebeault  was  a  sim- 
ple country  practitioner  in  the  neighborhood  of 
Nancy  and  few  people  paid  any  attention  to  his  book 
when  it  came  out  about  the  year  1870.  In  his  youth 
he  had  been  interested  in  animal  magnetism,  but  only 
in  riper  years  did  he  get  the  opportunity  to  occupy 
himself  completely  with  these  studies.  He  had  gone 
on  for  about  ten  years  with  the  investigation  of  such 
phenomena  from  his  new  viewpoint,  before  he  dared 
showed  himself  before  the  sqientific  World.  But 


Wetterstrand  and  the  Nancy  School        59 

neither  the  thoroughness  of  his  work  nor  the  force 
of  his  own  conviction  could  break  down  the  opposi- 
tion which  immediately  arose  against  him.  It  was 
only  when  Bernheim,  Professor  of  Medicine  at 
Nancy,  began  to  intervene  for  his  sake  that  things 
came  into  a  more  favorable  light.  This  happened  in 
1882.  Bernheim  and  Liebeault  were  drawn  together 
by  a  mutual  friend.  Bernheim  came  to  him  a  scoffer, 
but  he  went  away  convinced.  It  was  not  long  before 
he  was  deeply  plunged  into  the  study  of  suggestion, 
nor  was  it  long  before  his  own  great  work  upon  that 
subject  came  out.  That  this  became  the  foremost 
authority  for  the  use  of  treatment  by  suggestion 
has  its  special  reason.  Because  of  his  greater  scien- 
tific achievement,  Bernheim  succeeded  in  clothing  the 
new  ideas  in  a  manner  which  did  much  to  simplify  the 
amalgamation  of  them  with  academic  learning.  It 
can  by  no  means  be  denied  that  this  had  great  im- 
portance, but  it  remains  another  question,  if  this  by 
itself  was  favorable  for  the  highest  possible  develop- 
ment of  these  ideas  into  clarity  of  understanding  and 
ability  to  endure.  For  my  part  I  believe  that  the 
spreading  of  these  ideas  was  due  to  a  kind  of  popu- 
larity which  was  nevertheless  fatal  for  the  future 
development  of  the  study  itself.  Another  reason 
for  this  position  which  Bernheim  obtained  as  the 
foremost  representative  of  the  new  branch  of  thera- 
peutics is  to  be  found  in  his  association  with  the 
scientific  world.  It  was  through  Bernheim  that 


60       History  and  Practice  of  Psychanalysls 

Liegeois  became  interested  in  the  matter  and  took 
hold  of  the  investigation  of  suggestion  from  a  judi- 
cial standpoint ;  and  it  was  on  Bernheim's  initiative 
that  the  Professor  of  Physiology,  Beaunis,  applied 
the  ideas  to  his  sphere  of  activity.  Above  all  it  was 
Bernheim  who  jumped  into  the  breach  in  the  great 
battle  against  Charcot. 

About  the  same  time,  that  the  investigators  men- 
tioned gathered  themselves  together  under  the  name 
of  the  Nancy  School,  Charcot  had  arrived  at  a  very 
similar  stage  of  progress  in  his  own  studies  among 
the  patients  at  Salpetrieres. 

The  name  of  this  hospital  was  given  to  the  school 
that  grew  up  about  him.  Charcot  had  begun  to 
study  the  importance  of  suggestion  in  connection 
with  hysterical  symptoms.  For  him  the  meaning  of 
suggestion  and  hysteria  was  so  interwoven  that  he 
came  to  look  upon  the  phenomena  of  suggestion  itself 
as  a  kind  of  disease  product ;  he  denied  at  the  same 
time  that  any  valuable  therapeutic  method  could  be 
based  upon  it.  It  was  this  that  called  forth  the 
controversy  between  the  two  schools.  The  combin- 
ing element  in  the  Nancy  School,  was  the  assertion 
of  the  all  powerfulness  of  the  process  of  suggestion : 
this  was  something  always  present  in  the  psychic  life 
of  the  human  being  and  it  could  always  be  used  to 
bring  about  a  favorable  change  in  the  course  of  func- 
tional diseases.  I  shall  not  take  up  this  controversy 
which  long  ago  lost  its  interest.  Neither  shall  I  dis- 


Wetterstrand  and  the  Nancy  School        61 

cuss  the  differences  of  opinion  which  arose  within  the 
Nancy  School  itself;  that  would  go  far  outside  the 
frame  of  these  studies.  I  will  merely  devote  a  few 
pages  to  what  I  consider  the  most  vital  kernels  of 
truth  in  all  which  the  Nancy  School  brought  out 
and  turned  over  for  further  elaboration,  to  those 
who  came  after.  And  for  that  I  need  only  confine 
myself  to  the  fundamental  work  which  has  been  al- 
ready mentioned. 

Liebeault  tries  to  explain  exactly  what  he  means 
concerning  suggestion  in  the  following  sentence : — 

An  idea  that  is  carried  over  to  a  sleeping  person 
by  means  of  a  gesture  or  other  communication,  with 
the  intention  that  a  physiological,  or  even  more,  a 
psychological  phenomenon  shall  be  brought  about 
through  this,  in  his  organism,  is  called  suggestion. 

In  most  of  the  later  efforts  to  make  the  idea  of 
suggestion  exact,  it  seems  to  me  two  faults  have 
been  committed : — either  this  idea  has  been  stretched 
out  to  such  a  degree  that  the  word  suggestion  nearly 
becomes  a  new  name  for  psychic  phenomena  in  gen- 
eral,— or  else  in  order  to  avoid  this,  there  has  been 
an  effort  to  force  it  back  within  limits  that  are 
false.  Liebeault's  carefulness  avoids  both  these  dan- 
gers. An  idea,  a  conception,  an  experience  in  gen- 
eral can,  under  unique  circumstances,  be  worked  out 
in  a  peculiar  way ;  can,  so  to  speak,  enter  as  an  in- 
tegral constituent  into  the  organism  and  in  a  cer- 


62       History  and  Practice  of  Psychanalysis 

tain  degree  become  a  deciding  factor  in  its  future 
fate.  Suggestion  differs  in  this  dynamic  respect 
from  the  ordinary  impression.  "It  is  thus  the  road 
from  imagination  to  reality,  from  appearance  to  en- 
tity which  in  its  most  inner  meaning  characterizes 
suggestion,"  says  Schmidkunz,  who  has  devoted  a 
bulky  volume  to  this  question.  It  might  be  simply 
said  that  suggestion  is  the  word  made  flesh.  The 
suggestibility  is  therefore  that  quality  because  of 
which  we  are  able  to  incorporate  within  ourselves,  to 
make  our  own,  that  which  we  experience. 

Little  by  little  Liebeault  went  deeper  into  this 
fundamental  phenomenon  and  learned  to  see  various 
disease  conditions  from  the  viewpoint  thus  obtained, 
so  that  the  idea  for  him  not  only  became  the  preser- 
vation of  life  for  the  organism,  but  also  its  forma- 
tive power.  "For  us  who  do  not  acknowledge  the 
existence  of  any  physical  process  which  is  not  inter- 
preted by  a  thought  or  fear  of  this,  for  us  there  is 
nothing  repulsive  in  insisting  that  it  is  the  outgoing 
unconscious  thought  from  the  brain  which  constructs 
and  supports  the  organism;  which  unceasingly 
watches  over  that  complicated  drivewheel  which  sus- 
tains existence."  This  may  sound  merely  like  a  para- 
dox and  it  is  hard  to  follow  Liebeault  in  his  evidence 
for  the  correctness  of  this  last  sharp  point  in  his 
opinion.  But  on  the  other  side  there  are  phenomena 
of  suggestion  which  only  with  the  greatest  difficulty 
can  be  interpreted  without  the  supposition  that 


Wett erst rand  and  the  Nancy  School        63 

imagination  plays  a  determining  role  in  the  whole 
life-process.  To  these  phenomena  belong,  above  all, 
the  so-called  skin  phenomena;  for  example,  the  pro- 
duction of  blisters  on  the  skin  without  external  in- 
fluence. Through  these  it  can  be  very  obviously 
shown  how  the  suggested  ideas  produce  a  decided 
organic  change.  In  opposing  oneself  to  Liebeault's 
exaggerated  ideas  of  suggestion,  and  in  trying  to  be- 
little them,  it  is  all  too  easy  to  forget  the  unex- 
plained facts  which  led  him  to  his  opinion. 

Of  far  greater  importance  than  this  physiological 
side  of  suggestion  is  the  psychological  side.  The 
constructing  and  regulating  of  life  from  within  is  a 
fact  of  unlimited  value.  "During  the  waking  con- 
dition the  individual  is,  because  of  the  attention, 
the  author  of  his  own  sensations,  ideas  and  plans." 

It  is  the  emphasizing  of  this  active  reproductive 
feature  in  the  process  of  life  which  is  real.  It  means 
a  study  in  detail  of  the  way  in  which  construction 
occurs  under  normal  circumstances,  if  one  wishes  to 
understand  how  functional  diseases  arise  through  dis- 
turbances in  this  condition,  through  transference  and 
complications  of  many  different  kinds.  Very  much 
of  that  which  appears  to  happen  automatically,  as 
for  example,  sleep,  really  comes  about  through  self- 
suggestion.  In  the  same  way  an  individual  suggests 
to  himself,  without  at  all  understanding  it,  many 
nervous  symptoms. 

When  Liebeault  later  on  was  called  upon  to  ex- 


64       History  and  Practice  of  Psychanalyris 

plain  the  phenomena  of  suggestion  he  was  altogether 
wrapped  up  in  the  psychology  of  the  attention.  Sug- 
gestion arises  through  a  one-sided  direction  of  an 
accumulated  attention  upon  a  certain  point.  In 
explaining  this  he  uses  such  terms  that  one  may 
easily  get  an  impression  that  he  is  trying  to  make 
of  the  attention,  a  kind  of  mystic  power.  It  is  this 
that  chiefly  gave  offense  when  his  book  came  out. 
Foville  said  in  "Societe  Medico-psychologique," — 
"Does  it  not  seem  as  if  we  were  carried  far  back,  and 
as  if  Liebeault's  'attention'  is  nothing  but  a  new  name 
for  all  those  dominators  of  different  rank,  which  ac- 
cording to  Van  Helmont  should  direct  our  organs 
and  be  the  prime  movers  in  the  discharge  of  their 
functions?"  Naturally  Liebeault  intended  nothing 
of  the  sort ;  his  expression  was  purely  figurative.  But 
even  when  times  changed  and  his  work  was  given 
the  appreciation  it  deserved,  people  would  not  con- 
cur in  his  effort  to  explain  suggestion  absolutely  as 
attention-phenomena.  It  called  forth  numberless 
ideas  in  other  directions ;  but  all  these  rather  served 
to  make  the  question  more  vague  than  to  further 
elucidate  it.  An  effort  toward  the  disentanglement 
of  all  this  jumble  is  not  in  place  here.  But  if  any  one 
succeeds  in  some  time  carrying  it  through,  I  am  con- 
vinced that  it  will  show  that  no  one  has  come  nearer 
a  true  solution  of  this  question  than  Liebeault  him- 
self. In  spite  of  many  defects  he  had  a  simple  genu- 
ine grip  upon  the  problem,  which  may  well  require  to 


Wett erst rand  cmd  the  Nancy  School        65 

be  made  more  complete  and  deep,  but  which  never 
should  be  disregarded. 

The  question  concerning  the  importance  of  the  at- 
tention carries  one  directly  over  to  Liebeault's  opin- 
ion regarding  hypnosis. 

The  attention  became  for  him  a  kind  of  bridge  by 
means  of  which  he  connected  not  only  suggestion 
and  hypnosis  with  each  other,  but  also  both  these 
phenomena  with  commonplace,  well  known  things. 
The  line  of  thought  is  extraordinarily  simple  and 
can  be  gathered  together  in  a  few  lines:  during  the 
waking  life  the  attention  is  divided  by  the  sense  or- 
gans and  through  them,  by  all  the  impressions  re- 
ceived from  the  external  world  and  from  the  psychic 
rearrangement  of  these ;  it  is  not  only  diffused  among 
all  these  different  objects,  it  is  also  bound  up  in  them 
— immovable.  Where  connection  with  the  external 
world  is  cut  off  through  sleep,  the  organism,  so  to 
speak,  sinks  down  into  itself.  Then  a  radical  change 
occurs,  and  the  attention  which  before  was  bound  up, 
is  now  made  free.  It  draws  itself  back  therefore, 
from  all  those  things  by  which  it  has  been  split  up, 
into  the  organism,  into  the  nervous  system.  This 
shows  itself  in  an  accumulation  of  the  attention  in 
the  brain.  And  this  accumulated  attention  is  used 
up  during  sleep  in  the  reconstructing  process  of  the 
organism.  Such  regeneration  thus,  does  not  happen 
automatically  but  is  regulated  by  the  nervous  system 
through  something  which  has  intimate  connection 


66       History  and  Practice  of  Psychanalyn* 

with  the  psychic-life.  "Due  to  this  accumulation  of 
the  attention,  the  sleeper  not  only  has  the  faculty  of 
lessening  or  strengthening  the  activity  of  the  senses, 
that  is,  his  forces;  he  also  modifies  the  fabric  of 
them  with  a  magic  power ;  he  transforms,  he  creates ; 
in  this  way  he  is  able  to  bring  again  into  harmony 
the  forces,  which  during  the  day,  have  become  un- 
balanced." If  it  is  possible  to  get  into  communica- 
tion with  one  who  is  asleep,  the  attention  which  has 
so  been  made  free,  may  be  led  into  the  desired  path. 
It  is  so  possible  by  suggesting  certain  ideas,  to  direct 
regeneration  toward  a  selected  result.  During  such 
conditions  the  power  of  the  imagination  over  the  or- 
ganism is  increased  many  fold.  This  is  what  occurs 
during  hypnotic  suggestion.  Hypnotism,  according 
to  Liebeault,  is  nothing  but  a  state  of  sleep,  during 
which  the  subject  comes  into  rapport  with  the  opera- 
tor; hypnotic  suggestion  is  only  imagination  in- 
creased to  a  maximum  activity,  due  to  the  accumula- 
tion of  the  attention.  It  is  easy  to  see  how  all  that 
evil  of  mysticism,  in  which  animal  magnetism  had 
been  wrapt,  was  torn  aside  by  this  simple  interpre- 
tation. It  is  also  easy  to  see  how  this  became  the 
word  of  emancipation  for  many,  and  how  for  science 
it  became  possible  upon  such  a  basis  as  this,  to  take 
hold  of  the  treatment  of  nervous  disturbances  from 
the  psychic  point  of  view. 

But  unfortunately  this  view  of  the  matter  held 


Wetter  strand  and  the  Nancy  School       67 

also  a  seed  of  misconception,  which  became  fatal  for 
its  further  development. 

Braid  had  strongly  pointed  out  the  difference  be- 
tween sleep  and  hypnosis  and  in  so  doing  forcibly  laid 
claim  to  the  proposition  that  hypnosis  might  have 
another  and  more  widely  diffused  therapeutic  value 
than  sleep.  This  was  right.  But  through  Li£beault 
the  difference  between  sleep  and  hypnosis  was  more 
effaced,  and  with  his  successors  these  ideas  were 
entirely  fused  into  one.  Hypnosis  became  nothing 
but  a  suggested  sleep  and  had  no  specific  therapeutic 
action;  it  was  nothing  at  all  which  could  be  made 
an  object  for  study  in  itself,  it  was  only  a  phe- 
nomenon of  suggestion.  In  accepting  this  idea  the 
whole  line  of  treatment  was  directed  toward  sugges- 
tion ;  the  specific  action  of  hypnosis  itself  was  turned 
away  from,  denied,  and  as  a  result  there  was  no 
opportunity  to  ascertain  anything  further  about  it. 
In  just  this  circumstance  seems  to  me  to  lie  one  of 
the  reasons  why  the  work  done  by  the  Nancy  School 
did  not  bear  the  fruit  it  should  have  borne. 

But  there  is  also  another  and  s^ill  more  important 
reason  for  this ;  namely  the  distortion  of  the  idea  of 
suggestion. 

In  the  working  out  of  this  idea  Liebeault  had  pro- 
ceeded from  everyday  facts.  He  never  neglected,  so 
far  as  it  was  possible,  to  connect  his  statements  with 
things  which  every  one  could  prove  by  one's  own 


68       History  and  Practice  of  Psychanalysis 

experience.  But  when  later  he  had  to  bring  forth 
evidence  for  his  statements  and  to  demonstrate  sug- 
gestion with  such  clearness  that  it  should  command 
respect,  he  was  obliged  to  take  hold  of  psychological 
experiment.  His  followers  referred  continually  to 
this.  For  in  order  to  demonstrate  the  power  of  sug- 
gestion, one  must  experimentally  suggest  ideas  which 
necessitated  the  greatest  possible  opposition  to  over- 
come. When  the  privat  docents,  for  example,  saw 
suggested  criminal  scenes  carried  out,  in  which  the 
subject  not  only  murdered  his  victim,  but  also  showed 
the  most  agonizing  remorse  for  his  action,  etc.,  etc., 
they  began  to  wonder  if  something  was  not  brought 
to  light  therein,  which  might  be  worth  their  study. 
Unable  then  to  carry  their  experiments  over  from  the 
laboratory  to  real  life,  they  always  kept  such  ex- 
periments as  this  in  mind  when  they  spoke  of  sug- 
gestion. The  repellant  ideas  conveyed  to  the  subject 
at  these  experiments,  and  brought  into  actuality  by 
him,  became  for  them  the  general  prototype  for  sug- 
gestion. And  upon  this  prototype  is  based  the  qual- 
ity of  the  idea  itself.  And  this  went  so  far  that 
the  contrariness  of  reason  became  fixed  as  the  most 
mighty  characteristic  of  suggestion.  Theorists  have 
often  a  remarkable  faculty  for  destroying  the  work 
of  science. 

For  people  in  general  treatment  by  suggestion  re- 
ceived, in  this  connection,  a  smack  of  the  unreal,  a 
method  made  use  of  by  the  uncritical,  something  con- 


Wetterstrand  and  the  Nancy  School        69 

trary  to  logical  development,  etc., — everything  that 
tended  to  destroy  the  esteem  it  merited.  To  under- 
go hypnotic  treatment  was  the  same  thing  as  to  give 
up  one's  free  will  and  put  one's  self  wholly  under  the 
influence  of  another.  It  must  also  be  acknowledged 
that  among  those  who  practiced  this  treatment  there 
were  some  who  so  little  understood  their  work,  that 
they  did  endeavor  to  use  influence  in  this  banal  mean- 
ing. But  it  must  be  decidedly  denied  that  any  such 
thing  is  in  the  nature  of  the  method  of  the  treatment 
itself.  All  psychic  treatment  strives  after  the  free- 
ing of  forces  that  have  been  bound,  and  the  adjust- 
ment of  the  individual  to  that  external  reality  in 
which  he  must  live; — from  this  rule,  hypnotic  treat- 
ment never  in  the  slightest  degree  departs. 

The  ideas  that  grew  out  of  the  Nancy  School 
spread  with  rapidity.  The  new  branch  of  thera- 
peutics was  accepted  and  took  fast  root  in  most  of 
the  countries  of  Europe.  In  Switzerland  it  came 
through  Forel,  in  Holland  through  Reutergehm  and 
Van  Eeden,  in  England  through  Bramwell,  in  Austria 
through  Krafft-Ebing  and  Freud,  in  Germany 
through  Moll,  Schrenck-Notzing,  Hirschloff  and 
others.  Everywhere  in  medical  circles  arose  similar 
discussions  and  disagreements  as  in  France.  Neurol- 
ogists in  general  placed  themselves  on  the  side  of 
their  master,  Charcot,  and  those  who  sought  to 
specialize  in  the  new  direction  lost  much  strength  in 
strife  against  his  authority. 


70       History  and  Practice  of  Psychanalyrit 

That  suggestive  therapeutics,  in  spite  of  the  lively 
interest  in  it,  which  went  on  during  the  decade  from 
1880-1890,  did  not  come  to  occupy  the  more  import- 
tant  role  in  medical  specialties,  which  it  did  occupy 
later  on,  seem  to  me  to  depend  much  upon  the  reasons 
here  given.  There  is  also  another  reason  for  this. 
Traditionally  medical  science  has  been  directed 
toward  the  phenomena  of  physical  disease.  This  tra- 
dition may  go  thousands  of  years  back,  possibly  even 
to  that  period  when  the  original  unity  between  thera- 
peutics and  religion  was  broken  into  two  spheres  of 
activity,  and  when  the  care  of  mental  disturbances 
and  aberrations  was  relegated  to  the  religious  field. 
In  every  case  it  has  been  so  deeply  seated  in  the  gen- 
eral medical  consciousness  that  physicians  neither 
ought  nor  must  be  permitted  to  take  charge  of  the 
psychic  side  of  disease,  that  it  has  needed  decades 
to  unsettle  this  dogma.  From  my  own  student  days 
I  recall  how  the  professor  at  once  remarked  it,  if  in 
a  case-history  a  student  touched  upon  those  conflict- 
ing factors  out  of  which  a  disturbance  of  this  sort 
arose,  although  it  were  in  connection  with  such  a 
common  thing  as  alcoholism,  which  in  no  way  at  all 
can  be  understood  without  knowledge  concerning 
these  connections.  While  every  group  of  purely  phy- 
sical disease  is  represented  at  each  great  seat  of 
learning  by  its  professor  and  it  clinic,  up  to  the  pres- 
ent time  there  is  no  professor  of  psychotherapy  in 
Europe.  When  physicians  take  up  its  practice  with- 


Wetterttrand  and  ih«  Nancy  School        71 

out  any  basic  knowledge  of  this  subject,  it  is  natural 
that  they  should  not  show  understanding  for  all  those 
streams  of  thought  that  have  been  set  in  motion 
through  different  sources.  In  the  science  of  medi- 
cine, however,  co-operation  between  colleagues  is 
needful,  and  every  branch  of  it  which  is  lopped  away 
from  this  co-operation  must  little  by  little,  wither. 
The  sick  often  feel  only  a  general  diminishing  of 
force,  not  even  knowing  if  this  has  physical  or 
psychic  significance;  it  is  the  physician's  duty  to 
make  this  clear,  and  it  is  only  the  united  experience 
of  the  different  representatives  of  the  medical  corps, 
that  can  aid  in  so  doing.  One  reason  for  the  stunted 
growth  of  treatment  by  suggestion  seems  to  me  to 
lie  in  the  simple  fact  that  it  lacks  fertile  soil  in  the 
medical  corps  itself.  It  is  only  necessary  to  glance 
through  the  reports  of  some  present  day  discussion 
to  comprehend  this. 

In  our  own  medical  society  the  subject  of  hypno- 
tism was  first  brought  forward  by  Bjornstrom  in 
February,  1885.  The  chief  inducement  for  this  was 
that  he  wished  to  fix  the  attention  of  his  colleagues 
upon  the  danger  of  public  performances  like  those 
which  a  Danish  magnetiser,  named  Sixtus,  was  giv- 
ing. For  the  first  time,  the  subject  came  into  general 
discussion  in  February,  1885.  Here  Wetterstrand 
made  his  appearance  and  presented  some  practical 
experiments.  He  referred  to  the  work  which  had 
already  begun  to  appear  in  print  in  "Hygiea"  and 


72        History  and  Practice  of  Psychanalysis 

which  the  same  year  came  out  in  book  form  under 
the  title  "The  Use  of  Hypnotism  in  Practical  Medi- 
cine." 

But  Wetterstrand,  unfortunately,  was  not  the 
type  of  man  to  break  through  the  opposition  which 
here,  as  elsewhere,  arose  against  the  new  experiment. 
Admitting  that  the  unpretentious  way  in  which  he 
presented  his  observations  commanded  the  respect 
of  a  number  of  his  hearers  and  inspired  a  few  to 
themselves  make  a  trial,  little  more  came  of  it.  Into 
an  integral  constituent  of  therapeutics,  which  it  is 
each  practitioner's  duty  to  know  just  as  well  as 
every  other  branch,  he  was  unable  to  bring  treat- 
ment by  suggestion,  no  matter  how  earnestly  he 
strove.  And  this  was  not  only  because  of  circum- 
stances in  general  but  because  of  personal  qualities 
in  Wetterstrand  himself. 

Science  demands  exact  evidence  before  accepting 
new  ideas.  It  concerns  itself  only  with  final  obvious 
causal  connections,  and  it  tolerates  neither  wavering 
indecisions  nor  incompleteness.  Where  it  concerns  a 
therapeutic  process  it  means  nothing  to  say :  the  pa- 
tient was  so  and  so,  I  have  done  this  and  now  he  is 
well.  Science  demands  the  laying  forth  of  a  neces- 
sary causal  connection  between  the  first  state  and 
the  last.  It  must  give  the  observer  an  insight  into 
that  play  of  forces  out  of  which  the  disease  grew  and 
show  how  these  forces,  which  by  some  therapeutic 
means  are  set  in  motion,  counteract  and  overcome  it. 


Wetter  strand  and  the  Nancy  School        78 

Wetterstrand's  case  histories  are  singularly  naive. 
They  give  rise  to  numberless  questions  that  remain 
unanswered  and  by  criticism  nothing  is  easier  than 
to  crumble  them  to  pieces  one  after  the  other.  It 
was  not  in  Wetterstrand  to  work  out,  in  a  logical, 
scientific  way,  that  which  he  saw  take  place  in  his 
treatment  rooms.  He  was  a  practitioner  who  acted 
on  the  spur  of  the  moment,  intuitively,  and  he  had 
intellectually  about  as  little  understanding  of  that 
which  was  evident  in  his  methods,  as  an  artist  has 
for  that  which  happens  when  a  living  work  grows 
beneath  his  hands.  Spontaneous  action  is  one  thing 
and  the  conscious  laying  clear  of  the  inner  progress 
of  it  is  quite  another.  Qualifications  in  both  direc- 
tions may  possibly  be  united  in  one  individual;  but 
it  is  sure  that  they  were  not  so  united  in  Wetter- 
strand.  One  of  his  patients  has  told  me,  when  he 
felt  the  chaotic  disturbance  of  his  mind  clear  away 
in  a  wonderful  manner  during  his  treatment,  that 
he  could  not  withstand  the  temptation  to  ask :  "But 
tell  me,  doctor,  how  does  this  strange  thing  happen?" 
Wetterstrand  answered  with  a  kind  of  waggish  smile, 
that  was  peculiar  to  him:  "That  is  my  own  secret. 
But  if  you  promise  not  to  give  it  away  I  will  tell 
you :  I  do  not  know  myself !"  In  this  way  his  treat- 
ment often  went  on,  with  little  reflection  on  his  part. 
So  it  was  but  a  natural  consequence  that  he  was  af- 
terwards unable  to  demonstrate  scientifically  what  he 
accomplished,  in  such  a  way  as  to  convince  a  sceptic 


74        History  and  Practice  of  Psychanalysis 

from  the  outside.     The  whole  thing  must  often  re- 
main a  secret  between  him  and  the  patient. 

Even  if  Wetterstrand's  work  thus  did  not  con- 
struct any  valuable  stratum  in  the  scientific  archives, 
it  is  far  beyond  all  doubt  that  he  was  a  tower  of 
strength  on  the  road  to  health  for  innumerable  peo- 
ple. His  great  reputation  was  not  an  accidental 
one  but  was  based  upon  genuine  ability.  The  foun- 
dation for  it  is  to  be  found  finally  in  those  features 
of  his  nature,  which  I  pointed  out  in  the  beginning 
of  this  paper.  Only  one  who  is  so  over-sensitive  to 
suffering  as  he  was,  can  teach  himself  to  intuitively 
understand  the  sick.  And  it  is  in  this  understand- 
ing that  the  mystery  of  suggestion  to  a  great  degree 
is  to  be  found.  Everyone  knows  the  marvelous  re- 
sult achieved  by  finding  some  one  who  really  under- 
stands that  which  lies  nearest  his  heart.  When  this 
happens  the  whole  attention  expands  and  the  indi- 
vidual is  really  stirred  by  what  he  hears.  The  more 
thoroughly  one  human  being  understands  another, 
just  so  much  more  sensitive  that  one  becomes  to  the 
other's  judgment — and  just  so  much  greater  power 
is  awarded  the  one  over  the  other's  life.  This  hap- 
pens instinctively.  For  to  give  some  one  who  under- 
stands power  over  one's  life,  is  actually  the  same  as 
to  will  added  power  over  it  for  one's  self.  The  out- 
sider thus  plays  only  the  role  of  a  sounding-board 
which  strengthens,  supports,  lifts  up,  the  one  who  is 
struggling,  the  one  who  left  to  himself  would  wither 


Wetterstrand  and  the  Nancy  School        75 

and  dry  like  a  leaf  before  the  wind.  Suggestion  is 
the  strengthening  of  this  central  point  in  the  individ- 
ual, through  which  he  may  be  lifted  to  the  dominat- 
ing reality  of  life.  In  Wetterstrand  this  under- 
standing, by  means  of  which  he  won  suggestive  power 
over  the  sick,  remained  more  a  thing  of  feeling.  We 
stumble  upon  a  factor  in  his  method  of  treatment 
here,  which  cannot  be  more  closely  cleared  up.  Life 
itself  is  not  accessible  to  scientific  analysis  and  never 
will  be;  with  the  very  analysis,  that  unity  which  is 
its  innermost  essence,  falls  asunder,  it  starts  up  nejv 
spheres  of  phenomena  which  may  be  further  worked 
out  by  thought,  but  which  never  by  this  means  can 
be  carried  back  to  the  uncomplicated  origin  of  it.  It 
is  the  same  in  greater  or  less  degree,  with  everything 
that  has  to  do  with  those  central  occurrences  in  the 
individual's  inner  life,  or  in  the  mutual  circumstances 
of  life  between  individuals.  The  same  thing  applies 
also  to  that  which  happens  when  one's  understanding 
of  the  emotions  releases  forces  which  have  been  im- 
prisoned and  when  contact  with  an  unfamiliar  will 
serves  to  drive  the  personal  development  on  toward* 
a  more  harmonious  state  of  existence. 

It  is  not  only  in  this  way  that  there  is  difficulty  in 
molding  such  thoughts  into  scientific  form.  Even 
more — each  effort  in  this  direction  acts  as  an  ob- 
struction. Every  artist  knows  that  when  reflexion 
blends  itself  in  with  the  work  in  hand,  there  is  an 
end  to  inspired  creation.  Something  like  this  holds 


76        History  and  Practice  of  Psychanalysis 

good  here  too.  In  order  to  reach  this  power  of  un- 
derstanding over  another,  that  other  must  be  ap- 
proached with  confidence.  His  point  of  view  and  his 
actions  must  be  accepted.  And  this  acceptance  must 
be  so  far  reaching  that  it  will  appear  a  self-evident 
proposition  that  he  could  not  have  seen  or  acted 
otherwise.  To  this,  nothing  can  be  more  opposed 
than  that  critical  sharpness  with  which  every  in- 
vestigator must  approach  his  object.  "I  cannot  ex- 
pect a  patient  to  have  confidence  in  me,  if  I  have  none 
in  him,"  I  heard  Wetterstrand  say  one  day.  But 
to  have  confidence  in  a  morphinist  is  about  the  same 
as  to  "be  pulled  by  the  leg.'*  The  physician  easily 
comes  upon  the  following  dilemma ;  either  unbounded 
confidence  and  happy  results,  of  which  a  few  are 
perhaps  illusory ;  or  a  critical  unbelief  and  practical 
experience,  which  surely  are  discouraging,  but  as  a 
reward  are  just  so  much  more  scientifically  sure. 
Wetterstrand  chose  unhesitatingly  the  former. 

Another  of  Wetterstrand's  characteristics,  which 
has  importance  for  a  comprehension  of  his  work, 
was  a  warm  feeling  for  life  and  belief  in  its  power, 
an  inexhaustible  stream  of  hope  and  confidence  in  the 
victory  of  what  is  good.  Thanks  to  this  he  could 
reconstruct  many  a  broken  life  and  conjure  forth 
some  glimmer  of  light  for  the  future,  even  in  the  most 
despairing.  But  also  because  of  this  was  the  value 
of  his  scientific  work  largely  reduced ;  his  case-his- 
tories sometimes  bear  rather  the  imprint  of  that 


Wetterstrand  and  the  Nancy  School        77 

which  he  himself  wished  to  see,  than  of  the  sad 
reality.  I  heard  once  one  of  his  patients  say :  "He 
asked  me  if  I  had  had  any  fits  and  I  answered  no; 
it  was  impossible  for  me  to  admit  that  I  had  had, 
when  I  know  how  depressed  the  truth  would  make 
him."  Nowhere  is  the  difference  between  the  prac- 
tical physician  and  the  scientific  researcher  so  clear 
as  here.  The  physician  must  with  all  his  forces 
turn  both  himself  and  the  patient  in  the  direction  of 
life  and  seize  every  hint  it  gives,  with  eagerness.  He 
must  cherish  each  thing  which  contains  the  seed  of 
something  which  may  be  worth  while,  so  that  its 
growth  may  not  be  checked.  He  must  augment  each 
impulse  towards  victory  so  that  a  belief  in  the  power 
to  be  victorious  may  be  enhanced,  for  without  this 
one  can  do  nothing.  And  in  a  similar  way  he  must 
belittle  all  signs  of  the  disease.  Suffering  is  some- 
thing unreal  that  should  disappear  before  the  only 
reality  that  exists, — the  everlasting  regeneration  of 
life.  It  will  not  do  to  accord  this  unreality  any  at- 
tention. But  such  ideas  have  nothing  to  do  with 
the  objective  investigation.  This  must  not  be  mixed 
up  with  any  such  estimation  of  value.  For  it,  each 
phenomenon  is  quite  simply  a  thing  to  be  inquired 
into ;  it  is  a  matter  of  indifference  whither  the  inquiry 
leads.  If  the  phenomenon  of  disease  is  the  object 
of  research,  it  is  only  necessary  to  verify  it  and  to 
make  clear  all  its  details. 

For  Wetterstrand  it  would  have  been  just  as  im- 


78        History  and  Practice  of  Psychanalysis 

possible  to  reduce  a  sick  person  to  an  object  for 
study,  as  it  would  have  been  for  Charcot  to  keep 
from  doing  this.  As  a  consequence  also,  Wetter- 
strand  never  won  the  confidence  that  was  accorded 
Charcot  by  his  fellow  practitioners.  This  hurt  him. 
And  he  never  quite  succeeded  in  resigning  himself 
to  it. 

Besides  his  book  on  "The  Use  of  Hypnotism  in 
Practical  Medicine,"  Wetterstrand  has  published 
only  a  few  shorter  articles ;  the  most  valuable  of  these 
seems  to  me  to  be  "Ueber  den  Kiinstlich  Verlangerten 
Schlaf."  Even  if  these  works  had  no  great  scientific 
value,  they  are  of  interest  in  some  respects. 

Because  of  his  intuitive  faculty  it  not  infrequently 
happened  that  Wetterstrand  hit  the  mark,  no  matter 
if  his  argument  was  very  halting.  As  an  example  it 
is  enough  to  cite  the  epilepsy  question.  When  he 
came  forward  and,  supported  by  a  series  of  cases, 
declared  that  epilepsy  could  be  radically  cured  by 
means  of  hypnotism,  he  was  met  only  with  disbelief. 
In  medical  circles  it  was  curtly  asserted  that  the 
cases  in  question  had  nothing  in  common  with  true 
epilepsy,  and  the  authorities  with  one  voice,  declared 
the  whole  thing  contrary  to  their  experience.  Fur- 
ther researches  have,  however,  shown,  that  even  such 
interruptions  of  the  continuity  of  consciousness, which 
have  the  perfect  epileptic  type,  may  be  of  psychic 
origin  and  so  be  cured  through  psychic  treatment. 
It  is  true  that  this  treatment  is  in  these  days,  used 


Wetterstrand  and  the  Nancy  School        79 

according  to  quite  other  principles  than  those  by 
which  Wetterstrand  was  led  to  his  conclusions;  but 
with  the  accumulation  of  new  experiments,  no  one 
may  put  Wetterstrand's  statements  aside  as  absurd- 
ities. It  will  always  remain  of  interest  that  he  dared 
protest  against  the  dogma  of  the  incurability  of  epi- 
lepsy, when  all  the  rest  of  the  medical  world  still 
believed  in  it. 

Another  thing  is  of  even  greater  interest. 

As  one  of  the  reasons  why  suggestive-therapeutics 
did  not  become  what  it  should  have  become,  I  have 
pointed  out  in  the  preceding  pages,  a  certain  twist- 
ing about  of  facts  concerning  it,  to  which  the  funda- 
mental principles  themselves  were  subjected,  chiefly 
because  science,  on  account  of  this,  was  driven  into 
a  cul-de-sac.  Wetterstrand  did  not  permit  himself 
to  be  dragged  into  this  epochal  current  of  thought 
in  the  same  way  as  did  the  others.  His  ideas  con- 
cerning suggestion,  he  always  brought  out  of  what 
was  real  about  him,  that  which  flowed  past  him  in 
his  actual  practice;  it  was  never  changed  into  a 
dead  product  of  the  laboratory.  Even  more  Wetter- 
strand's  independence  upon  the  question  of  his  idea 
of  hypnotism,  advanced.  Bernheim  was  coming  more 
and  more  to  interpret  all  phenomena  belonging  there- 
to as  expressions  of  suggestion.  Hypnosis  itself  was 
to  him  only  a  phenomena  of  suggestion.  On  account 
of  his  authority  this  idea  impressed  itself  upon  the 
scientific  consciousness.  His  categorical  sentence, 


80        History  and  Practice  of  Psychanalysis 

"There  is  no  hypnotism.  There  is  only  suggestion !" 
became  a  kind  of  byword.  But  Wetterstrand's  work 
reached  out  towards  quite  an  opposite  direction. 
The  more  he  saw,  just  the  more  plain  it  became  to 
him  that  there  existed  a  peculiar  condition  of  con- 
sciousness, which  has  a  specific  therapeutic  action 
upon  the  organism.  In  this  he  was  closer  to  Braid 
than  to  the  Nancy  School  and  constructed  a  point 
of  contact  with  the  older  opinions,  whose  abandon- 
ment had  been  altogether  too  brutally  brought  about. 
The  great  basic  problem  for  him  was  to  find  a  way 
in  which  one  might  systematically  make  use  of  the 
therapeutic  value  of  hypnosis  in  the  highest  possible 
degree.  His  book  was  an  effort  towards  the  solution 
of  this  problem.  Theoretically  this  thing  appears 
simple: — an  effort  should  be  made  to  prolong  the 
hypnotic  condition  not  only  for  hours  but  for  days 
and  weeks.  It  is  a  pity  that  the  practical  demon- 
stration of  such  an  effort  meets  with  great  dif- 
ficulties. It  demands,  to  begin  with,  a  place  where 
the  patient  can,  during  sleep,  be  kept  free  from  all 
disturbing  influences;  this  cannot  be  done  either  in 
a  home  or  in  an  ordinary  sanitarium.  If  the  method 
is  taken  up  on  a  larger  scale,  a  house  must  be  built 
for  that  purpose.  Even  under  such  circumstances 
one  must  struggle  with  another  difficulty,  viz:  that 
the  method  places  unusually  great  demands  upon 
the  doctor.  As  a  rule  it  does  not  mean  one  or  two 
visits  a  day;  it  needs  three  or  four  in  order  to  con- 


Wetter  strand  and  the  Nancy  School        81 

tinue  the  hypnotic  condition  and  prevent  awaken- 
ing. 

But  when  it  came  to  practically  prove  his  ideaa 
and  make  plain  the  effectiveness  of  them,  all  such 
hindrances  gave  way  in  front  of  Wetterstrand's 
energy.  He  succeeded  under  the  most  unfavorable 
conditions  in  keeping  patients  asleep  for  a  whole 
month  at  a  stretch.  It  must  be  acknowledged  above 
all  doubt  that  inestimable  results  were  obtained  in 
this  way.  That  the  method  was  not  taken  up  by 
others  except  in  isolated  cases,  may  thus,  very  prob- 
ably depend  upon  the  practical  difficulties  attached 
to  it. 

Through  his  independence  regarding  these  two 
basic  questions  of  this  way  of  treating  disease,  it 
seems  to  me  that  Wetterstrand  has  made  a  contribu- 
tion which  must  not  be  underestimated. 

Far  from  leading  to  a  reduction  of  their  value, 
the  lines  he  followed  point  straight  towards  greater 
possibilities.  Whither  a  consequent  use  of  the  or- 
ganism's function  of  regeneration,  such  as  is  appar- 
ent in  hypnosis,  may  lead,  no  one  can  prophesy, — 
only  practical  experience  in  time  to  come,  can  show 
this.  But  it  is  certain  that  few  things  are  so  suited 
for  setting  a  physician's  imagination  in  motion  as 

just  this. 

*         *         * 

Wetterstrand  died  in  the  summer  of  1907. 
Later  years  have  carried  with  them  a  whole  series 


82        History  and  Practice  of  Psychanalyris 

of  new  ideas  which  from  the  very  foundation  have 
transformed  psychotherapeutics.  This  could  not  be 
lastingly  built  up  upon  relatively  undecided  and  un- 
certain experiences,  such  as  came  out  in  the  hypnotic 
literature.  It  demanded  a  far  firmer  grip  upon  the 
whole  of  medical  psychology  and  a  stronger  scientific 
working  out  of  the  processes  which  lead  to  disease 
and  to  health.  The  hopeful  nai'vity  of  the  practi- 
tioner had  to  give  way  before  the  cold  eye  of  re- 
search. Only  in  this  way  could  an  undisturbed  basis 
be  reached  such  as  science  must  and  does  demand. 

The  development  of  the  subject  has  brought  all 
the  old  disputes  into  a  new  position  and  has  given 
rise  to  many  others. 

My  effort  in  the  following  studies  will  be  to  give 
an  idea  of  this  development  and  afterwards  to  try 
to  show  whither  psychotherapy,  after  passing 
through  this  state  of  scientific  growth,  seems  to  me 
to  lead. 


m 


PSYCHANALYSIS   AS  A   SCIENCE   AND   METHOD  OP 
TEEATMENT 

MEDICAL  psychology  finds  itself  at  the  pres- 
ent time  in  an  especially  notable  period  of 
development.  Historically  there  are  only  two  epochs 
which  can  be  compared  in  importance  with  it,  viz: 
that  of  somnambulism  in  the  beginning  of  the  nine- 
teenth century  and  of  hypnotism  in  1880.  Looked 
at  from  a  distance  it  seems  as  if  the  movement  in  the 
midst  of  which  we  now  are,  had  a  great  many  points 
of  comparison  in  common  with  these  earlier  ones. 
Like  them  the  movement  has  in  this  case  chiefly  pro- 
ceeded from  a  single  man,  about  whom  a  great  many 
disciples  have  gathered  with  an  admiration  rare  in 
scientific  circles.  This  man's  name  is  Sigmund  Freud. 
He  is  a  professor  in  Vienna. 

If  one  reads  the  old  literature  one  cannot  help 
being  struck  by  a  certain  eagerness  displayed  there- 
in for  new  and  peculiar  experiences  along  with  a 
corresponding  neglect  of  critical  purging  of  mate- 
rial. New  literature  can  scarcely  be  made  free  from 
a  tendency  in  a  similar  direction. 

83 


84        History  and  Practice  of  Psychanalysis 

During  the  earlier  state  of  any  science  very  much 
will  be  brought  forth  which  later  shows  itself  of  no 
decided  value;  but  the  haste  with  which  doctrines 
here  follow  one  another  is  almost  enervating.  Just 
as  when  academic  medicine  stood  in  its  time  as  a  com- 
pact majority  against  the  old  schools,  must  be  re- 
peated here  the  same  thing.  Everywhere  the  new 
school  meets  with  an  intense  opposition.  At  the  as- 
semblage of  German  Neurologists  in  October,  1910, 
physicians  belonging  to  sanatoria  were  obliged  to 
officially  give  out  a  declaration  that  they  had  noth- 
ing to  do  with  psychanalysis,  and  Raimann  sug- 
gested that  neurologists  should  agree  among  them- 
selves upon  the  publication  of  every  case  in  which  it 
could  possibly  be  suspected  that  psychanalytical 
treatment  had  done  the  patient  harm.  At  the  con- 
vention of  alienists  in  Breslau  in  the  Spring  of 
1913,  the  discussion  was  more  heated.  Here  the  op- 
position was  led  by  Hoche  who  declared  that  the 
whole  idea  of  psychanalysis  was  to  be  considered  as 
a  psychic  epidemic  among  physicians.  Such  "intel- 
lectual rooting  like  a  pig"  ought  to  be  repulsive  to 
everybody.  He  summed  up  his  attack  with  the  fol- 
lowing sentence:  "The  only  lasting  interest  to  be 
found  in  the  psychanalytical  episode,  is  its  connec- 
tion with  the  sphere  of  the  history  of  culture." 

On  the  one  side,  its  partisans  believe  in  the  thing 
almost  to  the  point  of  fanaticism ;  on  the  other,  the 
attacks  of  its  opponents  against  it  often  seem  like  a 


Science  and  Method  of  Treatment  85 

revival  of  the  inquisition.  But  this  is  also  true  with 
doctrines,  which  not  only  are  of  fundamental  im- 
portance for  the  development  of  medicine.  They 
reach  out  into  one  field  after  another  connected  with 
human  life,  and  if  they  prove  to  be  true,  changes 
cannot  be  avoided ;  they  must  in  such  case,  with  time, 
also  obtain  a  widespread  general  cultural  import- 
ance. 


I  shall  in  a  few  words  point  out  how  these  new 
opinions  fitted  themselves  into  historical  develop- 
ment. 

About  the  beginning  of  1880  the  Vienna  physician 
Breuer  had  under  treatment  a  case  of  severe  hal- 
lucinatory hysteria.  He  used  hypnotism  in  order  to 
suggest  the  symptoms  away  in  the  usual  manner.  In 
the  somnambulistic  state  the  patient  began  to  talk 
about  the  origin  of  the  symptoms  and  little  by  lit- 
tle her  consciousness  stretched  out  over  a  mass  of 
forgotten  circumstances  which  therein  played  a  role. 
She,  herself,  noticed  that  the  symptoms  disappeared 
as  soon  as  their  hidden  causal  connection  was 
brought  into  consciousness.  This  patient  is  thus  the 
true  discoverer  of  the  psychanalytical  method. 
Breuer  understood  at  once  how  to  use  the  hints 
given  and  carried  out  the  consequent  treatment  un- 
til the  patient  by  means  of  this  "talking  cure"  as 


86        Hittory  and  Practice  of  Psychanalysit 

she  called  it,  was  made  free  of  all  her  symptoms. 
For  those  who  have  been  interested  in  this  much  writ- 
ten about  case-history,  I  can  add  that  the  patient 
had  to  undergo  a  severe  crisis  in  addition  to  what 
was  given  out  in  the  description  of  the  case.  Since 
then,  however,  she  has  lived  and  still  lives,  in  the  best 
health  and  in  widespread  activity. 

For  private  reasons  Breuer,  however,  did  not  go 
any  further  in  his  following  out  of  the  beginning  he 
had  made.  He  even  let  his  notes  lie  untouched  upon 
his  desk.  And  they  would  probably  still  be  lying 
there,  if  he  had  not  come  into  a  dispute  about  the 
thing  with  his  younger  colleague  Freud.  Freud  im- 
mediately suspected  the  importance  of  the  matter 
and  when  he  went  to  Paris  to  study  he  talked  it  over 
with  Charcot.  But  Charcot,  who  then  was  deep  in 
his  work  concerning  the  phenomena  of  hysteria  and 
the  experimental  causes  of  it,  had  no  interest  in  any 
new  experiments.  This  however  did  not  prevent 
Freud  from  coming  into  close  touch  with  Charcot, 
whereof  the  memoirs  inspired  by  gratitude  and  ad- 
miration, which  he  dedicated  to  him,  bear  witness. 
In  spite  of  all  his  approbation  however,  Freud  could 
not  help  pointing  out  the  faultiness  in  Charcot's  idea 
of  hypnotism.  Upon  this  question  Freud  united 
himself  with  the  Nancy  School  and  translated  Bern- 
heim's  book  into  German.  During  the  first  year  of 
his  practice  as  a  physician  Freud  also  devoted  him- 
self to  hypnotic  treatment;  but  his  attention  wai 


Science  and  Method  of  Treatment  87 

drawn  more  and  more  to  those  points  of  view  which 
had  come  to  him  through  Breuer's  case.  In  the 
year  1893,  he  published  the  first  results  of  his  psych- 
analytic  experiments,  and  he  then  wholly  gave  up 
the  practice  of  hypnotism  in  order  to  devote  himself 
absolutely  to  the  working  out  of  the  psychanalytical 
method.  In  the  year  1895  he  began,  his  lectures 
upon  this  subject  before  an  audience  consisting  of 
three  persons.  One  of  these,  Sadger,  has  since  fol- 
lowed him  steadily  and  practices  as  an  analyst  in 
Vienna.  Later  the  other  two,  Adler  and  Stekel,  al- 
lied themselves  to  him,  but  retained  their  independ- 
ence as  original  investigators.  The  Vienna  group 
grew  until  after  a  time  it  comprised  four  persons. 
In  the  beginning  of  the  year  1900,  a  branch  arose 
in  Zurich,  under  the  leadership  of  Jung,  who  up  to 
that  time,  next  to  Freud,  had  made  most  numerous 
literary  contributions  to  the  subject.  One  of  the 
members  of  the  Zurich  colony,  Abraham,  settled 
down  in  Berlin,  and  has  there  gathered  a  group  of 
followers  about  him.  Since  1906,  the  movement  has 
come  into  an  acute  state.  The  number  of  those  who 
have  officially  allied  themselves  with  the  School,  is,  it 
is  true,  not  so  great.  But  nevertheless  during  the 
last  year  most  neurologists  have  been  in  some  de- 
gree feeling  their  way  along  Freud's  road.  The 
questions  are  discussed  everywhere;  one  is  obliged 
to  take  a  standpoint  and  it  is  difficult  to  do  this 
without  at  least  some  apparent  personal  experience. 


88        History  and  Practice  of  Psychanalysis 

Interest  has  spread  itself  far  outside  German  speak- 
ing boundaries ;  to  Italy,  Russia,  France  and  Amer- 
ica. An  international  congress  is  held  yearly.  Dur- 
ing the  whole  of  this  development  there  has  been 
great  difficulty  in  keeping  the  members  together  on 
any  kind  of  united  scientific  program.  And  this  dif- 
ficulty finally  became  overwhelming.  In  the  Sum- 
mer of  1911,  Adler  separated  himself  completely 
from  the  rest  and  built  up  his  own  group  under  the 
name  "Verein  fur  freie  psychoanalytische  For- 
schung"  which  later  on  was  changed  to  "Verein  fur 
Individual  psychologic."  It  was  decreed  that  one 
could  not  be  a  member  of  both  schools,  and  the  strife 
arose  that  still  is  going  on.  What  this  means  I  will 
more  closely  point  out  in  the  next  paper.  Most  of 
those  interested,  allied  themselves  with  either  the  one 
or  the  other  group.  Some  preferred  to  keep  them- 
selves more  at  a  distance  and  to  avail  themselves  of 
anything  essential  which  proceeded  from  either  side. 
Just  now  there  is  going  on  a  new  division.  It  seems 
to  be  harder  and  harder  for  the  Vienna  school  and 
the  school  at  Ziirich  to  work  together ;  I  shall  touch 
upon  the  most  important  questions  between  them 
in  my  last  study. 

In  connection  with  this  schism  the  editing  of  the 
psychanalytical  movement's  journal  during  the 
course  of  three  years,  had  undergone  much  change. 
"Jahrbuch  fur  psychoanalystiche  Forschungen'1 
which  is  intended  to  take  up  greater  original  work 


Science  and  Method  of  Treatment  89 

has  hitherto  been  looked  after  by  Jung,  but  with  this 
year  he  steps  out  of  the  editorial  chair.  "Zentral- 
blatt  fiir  Psychoanalyse,"  was  founded  by  Stekel 
and  Adler.  The  latter  went  out  at  the  time  of  the 
rupture  with  Freud,  but  when  Freud  some  time  after 
also  tried  to  get  rid  of  Stekel,  the  result  instead 
was  that  he  himself  had  to  step  back. 

The  paper  continues  to  be  edited  by  Stekel  and 
bears  a  strong  mark  of  Adler's  spirit.  The  Freud 
dogmatism  has  now  as  its  chief  organ  "Inter- 
nationale Zeitschrift  fiir  Artzliche  Psychoanalyse" 
which  is  edited  by  Ferenczi  and  Rank.  Freud  also 
issues  a  periodical  called  "Imago"  with  Rank  and 
Sachs  as  editors;  the  object  of  this  is  to  apply 
Freud's  doctrines  to  the  humanistic  sciences  in  gen- 
eral. Besides  this  a  continual  series  of  detached 
works  come  out  under  the  name :  "Freud's  Schriften 
zur  Angewandten  Seelenkunde."  And  Adler  has 
under  his  patronage  a  similar  series :  "Schriften  des 
Vereins  fiir  freie  psychoanalytische  Forschung."  In 
addition  to  these  a  great  many  psychanalytical 
articles  appear  in  the  usual  medical  and  pedagogical 
journals. 

A  gigantic  work  is  produced  by  the  psychanaly- 
tical investigators  which  carries  the  movement  not- 
ably ahead  both  in  inner  and  outer  development, — 
not  only  for  every  year  but  even  for  every  month. 
One  would  have  to  be  especially  blinded  by  his 
academical  conservatism  in  order  to  find,  with  this 


90        History  and  Practice  of  Psychanalysis 

work  before  him,  that  psychanalysis  is  in  its  death 
throes,  as  Hoche  declared  it  to  be,  at  the  Congress 
before  mentioned.  In  this  declaration  he  had  in 
mind  all  the  various  schisms  that  were  within  the 
movement;  but  far  from  bearing  witness  to  any 
loss  of  strength,  the  movement's  power  of  expansion 
is,  on  the  contrary,  plainly  to  be  seen.  Yet  this 
makes  it  almost  an  impossibility  to  give  a  united 
picture  of  the  whole.  In  order  to  simplify  the 
problem  to  some  degree  I  shall  in  this  paper,  deal 
exclusively  with  Freud  and  with  the  work  of  his 
immediate  pupils  who  round  him  out  on  one  point  or 
the  other.  And  in  order  to  at  least  reach  an  ap- 
pearance of  lucidity  I  shall  confine  myself  to  main 
characteristics.  I  intend  to  do  this  as  objectively 
as  possible  without  unnecessarily  mixing  in  my  own 
ideas. 


The  first  difficulty  met  with  concerning  Freud's 
teachings  is,  that  they  by  no  means  constitute  a 
system  which  may  be  lightly  glanced  over.  They 
are  rather  a  chaos  of  efforts  to  explain  and  fix  enor- 
mous masses  of  results  of  experiments.  Antagonists 
often  remark  that  it  is  altogether  a  theory ;  but  this 
objection  is  quite  out  of  place  here. 

The  synopsis  is,  on  the  contrary,  difficult  of  at- 
tainment just  because  the  theoretical  construction 


Science  and  Method  of  Treatment  91 

work  has  been  so  much  put  aside.  This  may  seem 
like  a  defect  when  it  comes  to  giving  a  connected 
presentation;  but  really  it  is  an  advantage.  It  is 
all  too  easy  to  forget  that  the  object  of  the  psychol- 
ogist, the  human  mind,  is  filled  up  with  contradic- 
tions which  amalgamate  in  actual  life,  but  which 
never  could  be  theoretically  explained  together.  In 
the  face  of  every  psychology,  which  does  not  reflect 
the  nature  of  its  object,  it  is  easy  to  be  suspicious, 
to  notice  quickly  that  those  concerned  have  not  gone 
empirically  about  it,  but  have  let  themselves  be  led 
by  prejudiced  ideas.  Besides,  Freud,  in  the  whole  of 
his  makeup  is  no  theorist,  and  least  of  all  a  philos- 
opher. He  is  an  unusually  clear-minded  modern  in- 
vestigator, for  whom  only  the  discovery  of  new  facts 
has  value. 

In  order  to  counteract  all  those  criticisms  and  mis- 
understandings to  which  Freud's  psychology,  be- 
cause of  its  many  changing  forms,  has  been  sub- 
jected, Hitschmann  has  published  a  book  which  may 
be  called  the  first  text  book  in  psychanalysis.  But 
it  is  scarcely  anything  more  than  a  reference  to 
Freud's  most  important  writings,  with  connecting 
remarks  concerning  them. 

Unfortunately  critics  have  not  been  able  to  con- 
tribute anything  toward  elucidating  what  is  really 
essential  in  this  new  direction.  Even  where  the  work 
has  fallen  into  such  good  hands  as,  e.  g.  Isserlin's, 
it  has  remained  pretty  sterile.  On  the  one  hand 


92        History  and  Practice  of  Psyclianalysis 

Freud's  adherents  say:  "If  you  insist  that  we  are 
mistaken,  give  us  evidence  of  it."  On  the  other  hand 
his  antagonists  say,  "It  is  not  for  us  to  prove  fal- 
lacies, but  for  you  to  prove  the  truth."  And  there 
it  remains.  The  usual  way  in  which  each  empirical 
fact  which  an  investigator  declares  he  has  arrived 
at,  gives  cause  for  after-examination  by  others  be- 
fore opinions  are  expressed  concerning  it,  seems  here 
to  have  little  validity.  During  the  last  few  years  I 
have  myself  carried  out  many,  more  or  less  deep- 
going,  analyses.  I  have  in  this  way  found  confir- 
mation of  several  opinions  which  a  priori,  seemed  to 
me  unbelievable;  but,  there  are  many  others  about 
which  I  hesitate,  or  which  I  am  inclined  to  reject. 
Yet  in  every  case  Freud's  great  ingeniousness  and 
sweeping  importance  have  been  more  and  more  made 
clear  to  me. 

To  return  to  the  case  of  Breuer,  which  laid  the 
foundation  for  Freud's  research,  it  will  be  remem- 
bered that  it  succeeded  in  making  the  patient  free 
from  severe  hysterical  symptoms  by  means  of  tracing 
their  hidden  casual-connections  and  bringing  them 
back  into  her  consciousness.  Closer  study  led  to  the 
following  general  opinion  regarding  hysteria;  the 
symptoms  arise  through  the  fact  that  in  the  con- 
sciousness, intolerable,  emotionally  emphasized  ex- 
periences and  imaginations  are  forced  away,  denied 
and  made  unconscious.  This  process  Freud  calls 
"Verdrangung."  The  term  has  since  found  its  way 


Science  and  Method  of  Treatment  93 

out  into  everyday  speech  and  there  keeps  exactly 
the  value  Freud  gave  it.  It  is  difficult  to  find  a 
word  which  so  exactly  expresses  his  meaning  in  an- 
other language,  but  "repression"  seems  most  suitably 
to  convey  the  meaning  in  English,  although  it  misses 
a  little  touch  of  the  unconscious  which  lies  in  the 
word  "Verdrangung."  If  one  classes  it  as  an  indi- 
cation for  the  process  itself,  a  special  word  is  needed 
to  indicate  the  summing  up  of  that  which  is  forced 
out  of  the  consciousness.  It  may  be  best  to  keep,  in 
this  connection,  to  the  prevailing  German  term,  com- 
plex. When  in  ordinary  conversation  we  say  that 
we  force  away  our  anger,  it  simply  implies  that 
we  try  to  hinder  its  normal  outlet.  And  it  is  just 
in  this  prevention  of  a  releasing  outlet,  after  which 
with  innate  power,  the  emotion  immediately  strives, 
that  the  building  up  of  neurosis  lies.  Instead  of 
breaking  forth,  being  aired,  being  "abreacted,"  the 
emotion  is  suppressed.  In  its  simpler  form  this  proc- 
ess belongs  to  the  experiences  of  everyday  life. 
After  some  earnest  discussion,  it  has  surely  happened 
to  us  all,  that  we  have  clenched  our  hands  and  gone 
away,  smothering  by  sheer  force  of  will,  our  desire 
to  give  our  opponent  a  box  on  the  ear.  But  the 
road  from  such  everyday  experiences,  to  a  state  of 
ill  health  is  long.  Many  different  circumstances 
must  unite  before  a  functional  disease  can  be  con- 
stituted upon  the  foundation  of  a  repression.  Above 
all  the  repression  must  come  into  conflict  with  some 


94        History  and  Practice  of  Psyclianalysis 

sphere  which  has  for  the  individual,  the  highest  life- 
interest.  Freud  believes  that  there  exists  only  one 
such  sphere,  viz,  the  sexual-life.  Furthermore  the 
complex  must  fall  into  soil  fertile  for  the  progress 
of  disease.  Here  we  reach  the  grave  question  of 
the  importance  of  heredity  for  neurosis,  of  which 
Freud  treats  in  a  separate  work.  He  therein  opposes 
himself  to  what  originated  in  Charcot's  one-sided 
assertion,  to  the  effect  that  heredity  is  the  only 
essential  cause  of  neurosis.  Here  there  clearly  exists 
a  relative  condition.  The  stronger  the  burden  the 
less  is  needed  to  produce  an  illness.  With  a  strong 
and  thoroughly  healthy  individual,  not  even  the  most 
forceful  sexual  repression  need  mean  illness.  Ac- 
cording to  circumstances  it  may  lead  to  the  building 
of  character,  to  artistic  production,  or  something 
else  of  the  kind.  In  other  words,  the  forces  which 
have  been  discarded  to  a  place  in  the  unconscious 
mind,  need  not  seek  a  way  out  on  the  path  of  disease. 
They  may  rather  be  used  in  the  service  of  life.  This 
is  the  process  which  goes  under  the  name  sublima- 
tion. I  shall  refer  to  this  later  on. 

Suppose  now  that  an  individual  inclined  to  nerv- 
ous suffering  becomes  subjected  to  sexual  experiences 
from  which  he  must  free  himself  if  he  wishes  to  save 
his  emotional  life  from  becoming  a  prey  to  them. 
He  believes  he  has  succeeded  when,  in  the  struggle 
within  himself,  he  arrives  at  that  point  where  he  no 
longer  is  consciously  reminded  of  what  has  occurred ; 


Science  and  Method  of  Treatment          95 

when  in  other  words,  he  separates  the  experience 
from  the  complex  of  memories,  illusions,  feelings, 
etc.,  which,  collected,  are  called  the  ego.  But  in  the 
hidden  mind  the  overcome  emotion  may  live  on  and 
its  expansive  forces  may  stretch  their  activities  up 
into  the  consciousness  and  reach  it  in  such  form,  that 
the  connection  between  cause  and  effect  is  not  even 
conjectured  by  the  sufferer.  Hence  all  that  indeter- 
minate restlessness,  which  so  often  strikes  one  as 
soon  as  one  begins  to  talk  with  a  neurotic ;  hence  the 
sleeplessness,  the  anxiety  dreams,  the  state  of  de- 
pression, etc. 

Of  especially  great  importance  now,  we  must  re- 
member, is  the  fact  that  the  tension  on  its  way  from 
its  unconscious  source  to  its  release  in  disease,  may 
undergo  many  alterations.  The  tension  is  in  a  way 
disconnected  from  the  self;  neither  does  it  neces- 
sarily at  its  release,  break  out  in  those  parts  of  the 
nervous  system,  the  activity  of  which  has  intimate 
connection  with  conscious  processes;  it  may  imme- 
diately radiate  upon  nerve  courses  and  show  itself 
there  in  functional  pains,  paralyses,  cramps,  diges- 
tive disturbances,  etc.  Freud  calls  this  process 
Conversion.  No  matter  whether  the  disturbance  in 
a  given  case,  remains  in  the  psychic  sphere,  or  is 
transplanted  to  the  nervous  system,  Freud  carries 
it  back  to  a  constitutional  moment.  He  says  much 
about  greater  or  lesser  conversion-tendency.  It  is  a 
matter  of  much  consequence  then,  if,  so  to  speak, 


96        History  and  Practice  of  Psychanalysis 

any  organic  grip  is  given  to  the  unconscious  tension. 
The  organic  path  must  in  a  way  be  staked  out  for 
the  conversion ;  the  organism  must  come  to  meet  the 
strain.  Through  such  conversion,  for  example,  a 
lifelong  neuralgia  may  start  from  a  temporary 
toothache.  I  recall  a  patient  who  for  six  years  was 
continually  under  local  treatment  by  noted  special- 
ists, but  who,  nevertheless,  grew  continually  worse. 
The  psychic  origin  of  the  illness  was  entirely  clear. 
The  local  changes  had  as  a  matter  of  fact  played 
no  other  part  than  that  of  directing  the  conversion 
to  the  facial  nerves. 

Particularly  often  do  the  pains  of  occasional 
rheumatism  play  a  part  in  such  conversion.  I  had 
another  patient  who  suffered  from  severe  headaches, 
which  she  thought  were  of  rheumatic  origin,  as  she 
actually  did  suffer  from  that  disease;  but  the  chief 
cause  of  the  headaches  was  sorrow  for  the  loss  of  a 
sister.  This  sister  had  been  afflicted  with  headaches 
caused  by  pernicious  aenemia  and  my  patient  iden- 
tified herself  unconsciously  with  her.  Always  when 
local  treatment  for  such  suffering  is  not  followed 
by  freedom  from  pain,  one  should  suspect  that  some- 
thing psychic  lies  behind. 

This  conversion  doctrine  may  seem  strange  to 
those  who  assume  absolutely  the  physical  point  of 
view  of  all  nervous  disturbances.  I  will  therefore 
say  that  I  sometimes  find  patients  who  for  themselves 
are  successful  in  penetrating  such  connections.  I 


Science  and  Method  of  Treatment  97 

began  once,  e.  g.,  to  explain  this  thing  to  an  intelli- 
gent woman,  who  suffered  from  severe  neurotic  pain. 
She  interrupted  me  immediately  by  objecting:  "That 
you  do  not  have  to  explain,  for  I  already  under- 
stand it.  I  am  unhappy  and  my  mental  suffering 
must  localize  somewhere;  during  my  courses  the 
pain  localizes  in  those  special  parts:  if  anyone  of- 
fends me  I  get  palpitation  of  the  heart, — so  the  pain 
finds  a  place  in  the  heart ;  if  there  is  no  other  place 
where  it  can  settle  its  attacks  my  arm,  because  I 
broke  it  when  a  child  and  was  tormented  with  mas- 
sage for  a  whole  year." 

The  repression  doctrine  originally  concerned  it- 
self only  with  hysteria,  but  soon  began  to  be  ap- 
plied also  to  other  diseases, — compulsion-neuroses, 
anxiety-neuroses,  perversities  and  dementia-praecox, 
among  others.  It  was  found  upon  investigation  of 
these  that  analogous  mechanisms  play  a  great  part 
in  the  repression.  In  these  disturbances  they  would 
be  more  difficult  to  discover,  partly  because  the  re- 
pressed material  undergoes  greater  changes  before  it 
arrives  at  its  definite  form  as  a  disease  symptom; 
partly  because  sick  people  of  this  kind  are  less  ap- 
proachable for  deep-going  psychic  investigation ;  and 
before  all  because  the  repression  as  a  cause  of  dis- 
ease is  here  so  interwoven  with  many  other  causal 
threads. 

The  whole  of  this  doctrine  was,  as  Freud  himself 
pointed  out,  nothing  new  in  principle.  "The  fact 


98        History  and  Practice  of  Psychanalysit 

is  that  the  middle  ages  chose  this  solution  when  they 
declared  possession  of  a  devil  as  the  cause  for  hys- 
terical phenomena.  It  was  only  necessary  therefore 
to  insert  modern  scientific  terminology  in  place  of  the 
religious  expressions  which  were  in  use  during  this 
dark  and  superstitious  time."  So  simultaneously 
with  the  scientific  work  there  must  also  be  founded 
a  method  of  treatment  better  suited  to  our  times  than 
the  medieval  way  of  driving  out  evil  spirits. 

In  the  first  stadium  of  the  psychanalytical  method 
of  treatment  the  effort  was  to  "abreact  the  repressed 
affect."  Unconscious  causes  of  illness  should  be 
traced  and  made  conscious.  The  patient  should 
again  unite  the  ego-complex  with  what  he  had  tried 
to  force  out  of  it.  This  could  not  often  happen 
without  suffering;  the  emotion  bound  up  in  the 
symptom  was  often  made  free;  the  anxiety,  which 
had  been,  for  example  converted  into  neuralgia, 
again  became  anxiety.  The  treatment,  therefore, 
often  temporarily  produced  a  change  for  the  worse, 
sometimes  led  to  serious  crises.  But  it  must  at  last 
lead  to  health;  the  symptom  surely  had  its  possi- 
bility for  existence  in  the  quality  of  the  unconscious 
mind. 

The  original  somewhat  naive  belief  in  the  abso- 
lutely saving  virtue  of  the  unconscious  mind  no  long- 
er holds  together.  On  the  contrary  most  people  have 
a  certain  tendency  to  exaggerate  in  the  opposite 
direction  and  throw  awav  even  what  is  valuable 


Science  and  Method  of  Treatment  99 

and  lasting  in  such  an  idea.  To  me,  however,  there 
seems  no  doubt  that  the  consciousness  has  an  im- 
portance of  this  kind  in  mankind's  struggle  against 
destructive  experiences.  The  effort  so  common  with 
many  people  to  flee  away  from  life  in  fear,  often 
leads  them,  without  doubt,  to  a  flight  into  illness, — 
as  Freud  expresses  it.  By  freeing  them  from  this 
fear,  teaching  them  to  look  everything,  even  the  most 
tragic  experiences  of  life,  straight  in  the  eyes  and  to 
meet  new  misfortunes  with  open  mind,  by  so  doing, 
one  surely  will  have  made  them  stronger  and  sounder 
individuals.  But  naturally  such  a  method  of  treat- 
ment has  its  decided  limits.  It,  like  every  other 
one-sided  attempt,  must  sooner  or  later  be  reduced 
to  one  of  the  many  constituents  of  which  general 
psychotherapy  is  made  up. 


As  to  psychanalysis  as  a  method,  it  is  particularly 
difficult  to  give  a  clear  presentation.  To  afford 
anyone  a  genuine  conception  of  a  technical  method, 
with  no  material  for  demonstration,  but  solely  by 
means  of  description,  may  perhaps  be  possible,  in 
for  instance,  a  case  of  intubation  or  some  other 
operation,  provided  those  concerned  have  all  the 
anatomical  and  physiological  fore-knowledge.  But 
the  situation  is  more  difficult  when  the  most  com- 
plicated psychological  interference  is  brought  into 


100      History  and  Practice  of  Psychanalysis 

question.  Without  doubt  much  misdirected  criti- 
cism has  arisen  through  the  fact  that  neurologists 
have  looked  at  the  matter  solely  as  neurologists  and 
so  have  been  unable  to  judge  this  special  field,  which 
really  has  little  to  do  with  the  pedagogic  practice 
of  neurology.  Here  comes  in  an  important  thing: 
it  is  by  no  means  given  to  everybody  to  advance 
to  genuine  understanding  of  this  subject.  Psychol- 
ogy is  finally  based  upon  introspection.  Objective 
experiences  may  complete  our  subjective  experience 
but  taken  solely  by  themselves  they  can  never  give 
us  real  psychological  knowledge.  Without  the  natural 
analytical  inclination  and  without  having  been  accus- 
tomed since  childhood  in  some  degree,  to  make  clear 
one's  own  life  analytically,  nobody  can  be  taught  to 
understand  psychanalysis.  It  is  often  pointed  out 
by  analysts  that  no  one  ever  goes  farther  in  the 
analysis  of  another  than  he  has  gone  in  the  analysis 
of  himself.  Where  one  is-  blocked  in  an  analysis 
before  clear  comprehension  has  been  gained,  it  is 
sometimes  found  that  it  does  not  depend  upon  the 
opposition  of  the  patient,  but  upon  the  opposition 
within  the  analyst;  the  analyst  has,  in  other  words, 
come  in  contact  with  a  common  circumstance  of  life, 
which  he  has  not  dared  to  drag  out  into  the  light 
of  day  for  himself,  but  before  which  he  has  fled  in 
the  usual  neurotic  way.  Analytical  practice  de- 
mands of  the  doctor  not  only  a  highly  intensified 
faculty  for  self-analysis  but  also  a  highly  intensified 


Science  and  Method  of  Treatment        101 

faculty  for  self-honesty.  There  are  doubtless  many 
who,  because  of  this  fact,  beat  a  retreat  in  fright  at 
the  first  collision  with  the  difficulties  that  this  method 
carries  with  it,  and  thereafter  turn  angrily  against 
it.  The  great  opposition  toward  the  whole  trend  of 
the  matter  very  likely  has  its  root  partly  in  this  very 
fact.  Here  it  is  not  a  question  of  trying  to  break 
through  opposition  but  of  the  making  of  conditions 
clear.  Perhaps  the  originality  of  the  procedure  in 
some  degree  may  be  made  more  distinct  for  those 
analytically  disposed ;  for  the  rest,  this  presentation 
of  it  will  remain  only  a  "jumble"  as  Ziehen  expressed 
it,  regarding  psychanalysis  in  general. 

As  has  already  been  mentioned,  the  first  analyses 
were  made  during  hypnosis  and  a  few  writers,  as  for 
instance,  Muthmann,  still  ascribe  to  hypnosis  a  cer- 
tain importance  in  this  respect.  Freud,  however, 
soon  entirely  gave  up  hypnosis  and  most  of  his  pupils 
have  followed  his  example.  The  reason  for  this  is 
as  follows :  the  most  difficult  thing  about  analysis  is 
the  overcoming  of  the  inner  opposition  behind  which 
the  unconscious  seeds  of  illness  lie  defended.  During 
hypnosis  part  of  this  opposition  disappears.  This 
is  true.  But  the  old  opinion  that  the  unconscious 
mind  becomes  approachable,  without  the  control  of 
the  patient's  will,  is  a  great  mistake.  The  laws  of 
the  conscious  life  continue  to  hold  valid  even  in  the 
deepest  state  of  hypnosis.  In  using  hypnosis  it  may 
easily  happen  that  external  opposition  is  passed  by ; 


102      History  and  Practice  of  Psychanalysis 

but  afterwards  there  arises  a  wall  which  cannot  be 
broken  through.  In  carrying  on  analysis  in  the 
waking  state  it  is  true  that  in  the  beginning  the  prog- 
ress is  slow,  but  the  way  is  thus  better  paved  for  a 
deeper  advance. 

During  the  waking  life  a  stream  of  associations 
continually  flows  through  the  consciousness.  This 
stream  is  more  sharply  defined  the  more  the  attention 
is  directed  upon  one  decided  thing,  but  even  during 
the  most  purposeful  concentration,  strange  links  of 
association  often  present  themselves;  solitary  pic- 
tures which  have  nothing  to  do  with  our  line  of 
thought,  become  suddenly  conspicuous  and  then 
again  disappear.  The  more  we  dissociate  the  atten- 
tion, just  so  much  more  numerous  these  uninten- 
tional thought-pictures  become,  and  during  sleep 
they  take  possession  of  our  consciousness  in  the 
form  of  dreams.  Generally  we  consider  them  as 
psychological  accidents  not  worthy  our  attention, 
but  they  are  the  blending  in  of  our  unconscious  life 
with  the  conscious  actions  and  as  such  they  are  often 
worth  the  greatest  interest.  They  often  originate 
from  repressed  experiences  which  have  maintained 
such  a  strong  inner  tension  that  they  have  power  to 
break  through  even  the  strongest  conscious  thought- 
concentration.  When  during  psychanalysis  it  sim- 
ply means  the  bringing  of  these  experiences  to  light, 
the  ordinary  streams  of  association  are  looked  away 


Science  and  Method  of  Treatment        103 

from  and  instead,  attention  is  fixed  upon  those  that 
are  blended  in  with  them. 

To  begin  with,  one  tries  to  get  the  patient  to  dis- 
connect the  attention  and  to  relate  that  which  in  a- 
given  moment,  passed  through  his  head.  It  was 
Freud's  custom  to  lay  his  hand  upon  the  patient's 
head  and  say  "Now  when  I  press  with  my  hand  a 
thought  picture  will  present  itself."  By  thus  letting 
him  search  from  one  thought-picture  to  another  he 
gradually  got  the  chain  of  associations.  He  called 
this  the  "cathartic  method."  The  first  principle  in 
such  procedure,  is  the  avoidance  of  the  usual  anam- 
nestic  cross-questioning  as  soon  as  the  contour  of  the 
neurosis  becomes  clear.  The  patient  is  encouraged  to 
speak  freely  about  himself.  It  is  explained  to  him 
that  his  illness  is  nothing  but  his  unsuccessful  effort 
to  solve  the  conflicts  of  his  life.  It  is  wise,  as  quickly 
as  possible,  to  obtain  a  fairly  clear  insight  into  this 
connection,  in  order  that  the  patient  may  have  a 
feeling  that  he  is  understood.  This  often  solves  the 
problem.  "Whereof  the  heart  is  full  thereof  the 
mouth  speaketh;"  and  the  more  the  patient  speaks, 
the  better.  When  words  run  out  of  the  patient  with- 
out connection,  one  thing  after  the  other,  it  is  neces- 
sary to  follow  with  the  greatest  care  and  sharpness, 
all  links  of  associations  in  order  to  be  able  to  select 
just  those  through  which,  without  intention,  he  re- 
veals something  of  import.  It  will  not  do  to  let  such 


104      History  and  Practice  of  Psychanalysis 

material  be  lost  and  the  patient  must  be  encouraged 
to  follow  it  up.  One  picture  presents  itself  after  an- 
other until  recollections  which  have  lain  buried  in  the 
mind  for  decades  again  live  before  him.  It  strikes  him 
that  these  had  an  importance  of  which  he  hitherto 
had  not  had  the  slightest  inkling  and  this  importance 
must  be  interpreted  to  him  in  detail.  In  this  way  one 
shadow  after  another  is  evoked  from  the  hidden  past. 
Told  in  this  way,  here  in  a  few  lines,  the  thing  seems 
very  simple.  But  in  reality  it  often  meets  with  the 
greatest  difficulties  for  the  very  reason  that  it  lies 
in  the  nature  of  neurosis  to  guard,  with  all  the  force 
of  the  patient's  reserve,  those  secrets  that  lie  at  the 
foundation  of  the  trouble.  Opposition  belongs  to  the 
disease.  It  is  a  common  objection  that  one  is  act- 
ing against  the  will  of  the  patient  in  trying  to  break 
through  this  opposition.  On  the  contrary.  He  is 
helped  to  what  he  most  earnestly  desires,  but  which 
he  cannot  by  himself  attain.  The  neurotic  is  in  the 
position  of  one  who  wants,  but  is  unable,  to  love 
another ;  an  indeterminate  something  hinders  the  free 
action  of  the  feeling  which  really  is  there.  Just  as 
little  as  the  opposition  in  such  a  case  can  be  broken 
through  by  sheer  force  of  will,  just  as  little  can  this 
be  done  with  the  neurotic.  The  psychological  prob- 
lem is  more  involved  than  this. 

For  the  purpose  of  facilitating  the  bringing  to 
light  of  material  which  is  the  cause  of  a  psycho- 
neurosis,  there  are  a  few  technical  means  of  help  at 


Science  and  Method  of  Treatment        105 

our  disposal.     The  most  important  among  these  is 
the  dream-interpretation. 

It  is  well  known  that  those  things  which  we  try  to 
suppress  during  the  day,  often  come  back  in  the 
dreams  at  night.  So  one  initiated  in  dream  inter- 
pretation, may  often  even  find  traces  of  things  he 
has  suppressed  in  the  course  of  life.  It  was  there- 
fore natural  that  Freud  in  his  search  for  inadvertant 
outbreaks  of  the  unconscious  life,  should  turn  his  at- 
tention especially  to  dreams.  And  so  much  the  more 
because  he  was  continually  meeting  with  the  rela- 
tion of  dreams  during  his  analyses.  Patients  brought 
them  to  him  in  the  same  way  they  brought  their 
real  experiences.  He  also  soon  found  that  dreams 
were  established  in  psychological  processes  as  de- 
termining structures,  like  any  other  thought  struc- 
ture, only  with  the  difference  that  they  were  built 
according  to  other  principles  than  those  which  have 
to  do  with  the  waking  life.  The  thing  then  was  to 
discover  these  principles  and  learn  how  to  decipher 
this  strange  sign-language.  So  originated  that 
work,  based  upon  far-reaching  and  tedious  research, 
to  which  Freud  gave  the  name  "Traumdeutung." 
This  has  been  followed,  one  might  almost  say,  by 
nearly  a  whole  library  of  the  same  description.  The 
work  is  such  a  foundation  for  psychanalysis  that  it 
may  be  said  that  in  its  entirety  the  subject  is  encom- 
passed in  this  single  book.  The  ideas  therein  ex- 
pressed have  been  worked  out  and  applied  in  mani- 


106      History  and  Practice  of  Psychanalysis 

fold  ways  by  his  pupils;  some  lines  even  have  been 
elaborated  into  a  whole  book, — for  example,  The 
Jones-Hamlet  interpretation.* 

If  one  considers  the  dream  as  it  immediately  ap- 
pears before  the  consciousness,  it  ordinarily  seems 
quite  meaningless.  This  has  given  rise  to  all  the 
old  teachings,  according  to  which  the  dream  is  only 
a  conglomeration  of  dissociated  ideas,  originating 
through  the  fact  that  the  somatic  processes  tempo- 
rarily put  the  ruling  mental  apparatus  into  a  state 
of  irritation.  If  the  dream  is  subjected  to  analysis, 
it  takes  on  another  signification.  Dogmatic  ideas 
concerning  its  want  of  meaning  disappear  and  the 
importance  of  the  body  processes  in  the  construc- 
tion of  dreams  is  considerably  reduced. 

If  a  person  relates  a  dream  and  if  he  is  then  ques- 
tioned as  to  what  comes  into  his  mind  when  he  thinks 
of  it,  he  will,  as  a  rule,  reply: — nothing.  But  cir- 
cumstances are  changed  if  the  dream  is  separated 
into  its  elemental  parts,  and  the  person  is  then  asked 
to  think  over  each  and  every  detail  and  to  relate 
what  each  implies.  It  will  so  be  seen  that  every 
dream-element  will  awaken  lines  of  association  out  of 
the  waking  life's  experiences.  This  is  something 
which  everyone  may  try  for  himself ;  there  is  no  way 
in  which  it  is  possible  to  easier  obtain  a  first  insight 
into  the  nature  of  analysis.  If  an  anxiety-dream  is 
chosen,  one  gets  at  the  same  time  some  inkling  of  its 
*See  Freud,  "Traumdeutung." 


Science  and  Method  of  Treatment         107 

action ;  one  experiences  in  this  way  how  the  anxiety 
disappears  without  a  trace  of  it  being  left,  during 
the  analysis.  After  dissolving  one  element  after  the 
other,  instead  of  the  original  meaningless  dream-pic- 
ture, there  accumulates  vastly  multiplied  psychic- 
material  ;  and  it  is  found  that  this  dove-tails  into  an 
ingenious  thought-structure, — perhaps  sometimes,  at 
first,  with  the  help  of  a  certain  fantasy  and  always 
with  certain  flaws.  Instead  of  the  manifest  dream- 
picture  we  now  have  the  latent  dream-content  or 
dream-thoughts.  When  Freud  arrived  at  this  point 
in  his  investigations,  he  threw  aside  the  original  pic- 
ture and  the  whole  of  his  further  study  concerned 
itself  with  the  at  first  unconscious,  but  now  con- 
scious, material,  so  changed  about  through  analysis. 
This  is  something  that  must  be  constantly  kept  in 
mind,  when  Freud  speaks  about  dreams.  When,  for 
example  he  declares  that  every  dream  is  a  sexual 
dream,  he  means  only  that  the  sexual  life  always 
hides  itself  in  the  depths  of  the  constructive  forces 
under  the  manifest  pictures. 

It  would  carry  us  much  too  far  here  to  go  farther 
into  Freud's  dream  psychology.  For  the  sake  of 
connection,  however,  I  must  touch  upon  two  ques- 
tions with  which  it  especially  is  concerned:  1. 
Whence  originates  the  latent  dream-material?  2. 
How  are  the  manifest  dream-pictures  constructed 
out  of  this? 

"V,  The  material   changes  of  course,  to   a  great 


108      History  and  Practice  of  Psychanalysts 

extent  in  different  dreams,  but  it  is  a  thing  to  lay 
stress  upon  that  it  often,  to  an  astonishing  degree, 
originates  in  the  childhood.  Through  this  fact  the 
dream  attains  a  practical  importance  in  being  sin- 
gularly able  to  complete  that  part  of  life  which 
contains  the  largest  gaps  in  memory. 

2.  Concerning  the  construction  of  dreams,  it  is 
first  and  foremost  to  be  noted  that  the  dream  is  not 
logically  descriptive,  but  is  symbolically  represented : 
A  simple  picture  of  the  difference  between  the  way 
in  which  the  waking  consciousness  relates  something, 
and  the  dream  way  of  so  doing,  may  be  obtained  if 
the  difference  between  a  modern  monument  and  one 
of  the  ancient  Egyptian  type  is  thought  of.  Upon 
the  former  is  found  an  inscription  of  that  which  the 
stone  commemorates,  upon  the  latter  is  only  a  mass 
of  figures  and  lines  without  evident  connection;  the 
meaning  of  these  is  only  apparent  when  one  learns 
how  to  interpret  the  pictures  one  by  one  and  then 
puts  the  whole  together.  The  dream  in  the  same 
way  draws  one  picture  after  another.  Therefore  a 
study  of  the  dream-content  means  first  the  con- 
struction of  the  picture  in  itself  and  finally  of  the 
meaning  hidden  behind  the  symbol. 

In  regard  to  the  first  of  these  two  points  Freud 
considers  that  the  construction  of  the  dream  arises 
through  four  psychological  processes:  1.  Conden- 
sation. 2.  Displacement.  3.  Dramatization.  4. 
Censoring. 


Science  and  Method  of  Treatment        109 

Even  with  the  most  casual  observation  most  peo- 
ple have  probably  noticed  how,  in  a  dream,  two  or 
more  people  commonly  are  fused  into  one.  We  may 
for  instance,  recognize  some  one  in  the  dream  whom 
we  have  seen  the  previous  day,  but  while  in  reality 
he  had  a  black  mustache,  in  the  dream  he  appears 
with  a  blond  one  and  we  find  that  the  mustache  is 
taken  from  some  other  man.  In  a  similar  way  in 
the  dream,  a  pair  of  eyes  belonging  to  an  animal  may 
be  seen  in  connection  with  a  human  being.  The  con- 
densing process  may  be  yet  more  involved;  a  land- 
scape, a  person,  a  piece  of  furniture,  etc.,  may  for 
instance,  all  be  condensed  in  the  same  picture. 

Displacement  shows  itself  particularly  in  the^fact 
that  that  which  plays  the  chief  role  in  the  manifest 
dream-picture  by  no  means  has  the  same  importance 
in  the  dream-thought,  and,  therefore  in  reality. 
This  is  most  marked  in  the  sphere  of  affects.  Every 
one  knows  how  an  unimportant  thing  in  the  dream 
can  be  bound  up  with  the  strongest  kind  of  an  emo- 
tion, and  how  again  one  may  in  a  dream,  appear 
quite  naked  among  others,  without  feeling  the  slight- 
est disgrace.  The  affect  is  loosed  from  its  real 
connection,  transferred  to  some  indifferent  subject 
and  fixed  upon  it. 

The  dream  has  an  inclination  to  present  every- 
thing in  acoustic  and  visual  pictures.  It  does  not 
approve  of  the  narrative  form  but  is,  in  its  essentials, 
dramatic. 


110      History  and  Practice  of  Psychanalysis 

Freud  lays  great  stress  upon  the  fourth  point, 
censoring;  although  others  especially  Bleuler,  finds 
its  importance  more  doubtful.  That  a  higher  psychic 
court  of  appeal,  censors  that  which  a  lower  court 
produces,  belongs  to  the  experience  of  every  day 
life.  As  an  illustration,  the  following  example  may 
serve;  a  writer  feels  himself  inspired  and  lets  all 
that  forces  itself  up  through  his  consciousness  flow 
forth  from  his  pen.  When  later  on  he  reads  over 
what  he  has  written  he  notices  that  it  reveals  his  in- 
timate life  more  closely  than  he  desires.  He  then 
scores  through  a  line  here  and  there,  replaces  that 
which  he  had  expressed  directly,  by  symbols,  hides 
himself  behind  fictitious  figures,  etc.  His  reflecting 
ego  censors  his  spontaneous  productive  ego.  In 
the  same  manner  we  always  conduct  ourselves  when 
the  outbreaks  of  the  unconscious  life  during  sleep, 
seek  an  outlet  in  our  consciousness  in  the  form  of 
dreams.  Even  during  the  deepest  sleep  of  the  night, 
the  sentries  that  guard  our  consciousness  from  re- 
pressed experiences  do  not  slumber;  if  they  cannot 
prevent  these  experiences  from  forcing  a  way  in,  they 
at  least  play  such  havoc  with  them  that  we  no  longer 
recognize  them.  This  same  inclination  to  censor, 
continues  in  the  conscious  mind  when  it  is  fully 
awake.  If  a  person  relates  a  dream,  and  if  later 
on  he  is  asked  to  write  it  down,  it  is  a  foregone  con- 
clusion that  the  written  description  will  be  more 
strongly  censored  than  the  related  one.  It  is  this 


Science  and  Method  of  Treatment        111 

censoring  which  puts  the  keenness  of  the  dream-in- 
terpreter to  hardest  proof. 

But  what  complicates  dream-construction  most  of 
all  is  the  use  of  symbols.  The  study  of  symbolic 
presentations  has  more  and  more  come  into  promi- 
nence. Freud  soon  discovered,  when  he  turned  his 
attention  in  this  direction  that  symbolic  speech  by 
no  means  applies  only  to  the  dream.  It  is  a  common 
ingredient  in  the  conscious  mind  and  presents  itself 
now  here  now  there,  in  folk-lore,  in  witticisms,  in 
slang,  etc.  Closer  investigation  has  led  to  the  fol- 
lowing general  opinion,  the  accounting  for  which  I 
must  here  pass  by:  primitive  man  made  use  of  sym- 
bols as  a  means  of  expression ;  later,  our  logical,  de- 
scriptive speech  was  built  up  as  a  cultural  super- 
structure upon  this  foundation.  With  this,  however, 
the  use  of  symbols  has  not  disappeared.  It  remains 
in  the  waking  consciousness  as  a  fragmentary  admix- 
ture ;  and  what  is  far  more  important,  it  has  re- 
mained in  the  unconscious  mind  as  its  means  of 
expression.  During  sleep  it  again  takes  the  lead  in 
the  presentation  of  our  experiences.  And  when  the 
developed  consciousness  is  relaxed  during  periods 
of  mental  dullness  it  becomes  once  more  the  ruling 
force  for  the  life  of  imagination.  A  significant  point 
in  the  development  of  psychanalysis  was  Jung's 
presentation  of  the  analogies  between  the  fantasies 
of  dements  and  the  mythologidal  and  totemistic 
thought-products  of  primitive  peoples. 


History  and  Practice  of  Psychanalysis 

In  settling  upon  one  single  point  in  the  Freud  doc- 
trines, which,  in  importance,  exceeds  all  others  he  has 
brought  to  light,  I  should  suggest  his  clear  presen- 
tation of  the  connection  between  dream  psychology 
and  the  process  of  the  construction  of  neurosis.  It 
has  always  been  suspected  that  dreams  had  some- 
thing to  do  with  insanity.  But  until  Freud's  re- 
searches, this  remained  only  a  suspicion.  His  in- 
genuity was  the  first  that  succeeded  in  seizing  upon 
and  working  out  in  detail  this  apparently  inacces- 
sible empirical  material.  Psychoneurosis  is  a  flight 
away  from  reality  into  a  world  of  illusion.  And  the 
neurotic  takes  with  him  into  his  waking  life  a  part 
of  this  world  of  illusion;  he  finally  at  one  point  or 
another  becomes  influenced  by  the  forces  which  rule 
this  world.  Some  part  of  his  psyche  is  not  con- 
structed according  to  the  laws  of  the  waking  con- 
sciousness, but  according  to  those  rules  which  deter- 
mine dream  construction. 

By  giving  the  subject  close  attention,  it  will  al- 
ways be  found  that  just  those  processes  mentioned 
above,  continually  come  back  in  the  psychology  of 
neurosis. 

Condensation  implies  a  synthesis  between  things 
that  have  no  connection  in  substance,  but  are  only 
united  through  more  or  less  temporary  associations. 
Such  syntheses  play  a  great  part  in  thelife  of  the  neu- 
rotic, and  treatment  must  often  be  directed  toward 


Science  and  Method  of  Treatment        118 

an  effort  to  dissolve  them,  just  as  a  mere  temporary 
synthesis  is  broken  up  in  the  dream  interpretation. 

In  the  same  way  in  which,  during  a  dream,  an 
affect  is  made  free  from  its  actual  connection  and 
transferred  upon  some  indifferent  thing,  a  neurotic 
becomes  anxious  if  he  is  obliged  to  cross  an  open 
space,  touch  certain  objects,  be  left  alone  in  a  room, 
etc.  In  what  has  been  the  usual  treatment  the  effort 
has  been  to  convince  the  patient  that  his  anxiety  is 
groundless, — a  way  that  has  nothing  of  the  desired 
result,  when  the  connection  of  the  anxiety  with  the 
illusion  in  question  has  not  at  all  been  made  clear  in 
a  logical  manner.  The  psychanalyst  first  discovers 
where  the  anxiety  had  its  origin  and  then  makes 
clear  why  it  has  been  loosed  from  this  origin  and  in 
what  way  transferred  upon  some  other  unconcerned 
thing. 

As  to  the  dream's  inclination  to  present  everything 
in  pictures,  this  also  comes  back  here  in  a  variety  of 
ways.  It  is  most  striking  in  the  question  of  the 
hallucination.  The  transference  between  hallucina- 
tion and  particularly  vivid  dream-pictures  is  often 
obvious. 

That  the  neurotic  in  his  struggle  against  the  strain 
of  repressed  experiences,  unconsciously  makes  use  of 
the  censor  in  a  far  reaching  degree,  is  manifest.  I 
recall  for  example,  an  elderly  widow  who  had  a  per- 
petual hallucination  of  snakes ;  she  suffered  especially 
because  the  snake  forced  itself  into  her  abdomen, 


114      History  and  Practice  of  Psychanalysis 

wriggled  through  the  body  up  to  her  mouth  and 
from  there  spat  out  its  poison.  The  genuine  suffer- 
ing which  she  censored  in  this  way,  is  so  clear  that 
it  does  not  need  to  be  pointed  out.  From  this  coars- 
est form  there  is  a  continual  transference  to  that 
general  mendacity  which  is  so  often  met  with  in  hys- 
teria. This  woman  had  so  accustomed  herself  to 
unconsciously  clear  herself  from  her  varied  experi- 
ences by  means  of  lies,  that  at  last  she  was  neither 
able  to  feel  nor  tell  anything  which  was  not  entwined 
in  lies.  In  coming  across  patients  of  this  kind,  the 
first  thing  to  do  is  to  make  an  effort  to  introduce 
truth  into  their  lives. 

The  most  weighty  analogy  between  dream  and  neu- 
rosis-construction, according  to  Freud,  lies  in  the 
wish  motive.  He  is  of  the  opinion  that  the  dream 
always  contains  the  realization  of  an  unconscious 
wish,  and,  more  decidedly,  of  a  sexual  wish.  And 
he  believes  that  the  neurotic  in  a  similar  way,  lives 
out  his  repressed  impulses  in  the  form  of  nervous 
symptoms.  Unfortunately  I  can  not  here  take  up 
this  point,  which  at  first  glance  seems  preposterous. 
It  must  be  handled  in  a  far  broader  connection  and 
with  a  far  deeper  investigation  into  Freud's  line 
of  thought,  than  is  possible  here,  in  order  to  get 
any  clear  conception  of  what  it  implies.  There  is 
the  less  reason  to  stop  at  this  disputed  question,  as 
the  researches  of  later  years  seem  to  me  to  show 
the  impossibility  of  supporting  the  idea  as  Freud 


Science  and  Method  of  Treatment         115 

formulated  it.     I  shall  return  to  the  subject  in  my 
last  study. 


In  the  present  condition  of  things  I  believe  it 
would  be  too  rash  to  attempt  to  give  a  general 
verdict  concerning  psychanalysis  as  a  method  of 
treatment.  Altogether  too  much  is  going  on  in 
that  direction  to  make  possible  a  centralization  of 
one's  impressions.  I  shall  therefore  confine  myself 
to  certain  comments. 

Above  all  I  believe  that  it  is  a  fallacy  not  to 
separate  psychanalysis  as  a  science  from  psych- 
analysis  as  a  method  of  treatment. 

While  it  is  now  called  a  therapeutic  agent,  it  is 
nevertheless  of  a  kind  that  also  yields  scientific 
fruit.  So  it  may  easily  happen  sometimes,  that  it  is 
the  deference  to  science  and  not  to  the  patient  which 
is  the  deciding  factor  in  the  use  of  this  method; 
when  the  psychanalysis  of  a  single  case  is  spoken 
of  as  something  which  must  stretch  itself  out  over 
years,  this  point  of  view  must  be  taken  into  consid- 
eration. The  thing  is  placed  in  quite  another  light, 
if  treatment  of  the  patient  is  altogether  the  ob- 
ject in  view.  When  analysis  fits  itself  in  as  a  mo- 
ment in  that  unfoldment  which  is  expected  from 
the  treatment,  even  if  this  moment  in  a  given  case, 
is  the  chief  thing,  still  it  is  not  necessary  to  go  to 


116      History  and  Practice  of  Psychanalysis 

those  lengths  described  in  the  literature  upon  the 
subject,  nor  is  it  necessary  to  overload  the  analysis 
with  all  those  details  which  only  serve  to  make  it 
repellant. 

It  has  already  been  pointed  out  that  a  kind  of 
uncertainty  is  inherent  in  this  method  of  treatment 
and  that  it  can  scarcely  be  freed  from  the  subjec- 
tive element.  In  this  respect  psychanalysis  has,  and 
probably  always  will  have,  a  stamp  of  art.  The 
sculptor  may  hit  upon  a  likeness,  which  will  aston- 
ish everyone  who  has  any  feeling  for  art;  but  he 
cannot,  by  measuring,  weighing,  registering,  etc., 
demonstrate  that  likeness.  In  a  similar  way,  the 
psychanalyst  may  give  a  picture  of  the  whole  play 
of  unconscious  forces,  of  which  the  visible  result  is  a 
sick  human  life,  and  those  concerned  may  in  their 
innermost  hearts,  feel  that  this  picture  is  the  true 
one.  It  is  in  this  feeling  that  the  criterion  of  truth 
finally  lies.  All  efforts  to  attain  other,  more  scien- 
tific evidence  become  more  or  less  illusory.  This  may 
seem  a  weak  point  which  would  plainly  reduce  the 
value  of  psychanalysis.  But  it  is  a  question  if  the 
same  weak  point  does  not  and  must  not  always  be 
incidental  to  all  higher  psychology.  Just  as  soon 
as  we  try,  for  example,  to  force  it  into  the  physio- 
logical method  we  put  it  into  a  kind  of  straight- 
jacket  within  which  it  must  be  stifled.  If  this  is  true, 
generally  speaking,  it  must  be  especially  so  when 
investigation  tries  to  reach  out  toward  the  almost 


Science  and  Method  of  Treatment        117 

inaccessible  domain  of  the  unconscious  mind.  For 
here  furthermore,  are  complicated  all  those  circum- 
stances, which  make  it  impossible  to  fix  a  measurable 
value  upon  the  inconsistencies  of  the  human  mind; 
— here  all  the  different  expressions  of  the  struggling 
forces  cross  each  other  in  such  confusion,  that  pro- 
cedures which  are  admirable  in  the  simple  phenomena 
of  life,  become  unfit  for  use.  The  mapping  out  of 
the  unconscious  world  must  be  done  in  accordance 
with  personal  methods. 

It  is  wise  to  keep  always  in  mind  that  the  scientific 
purpose  of  psychanalysis,  is  simply  the  conquest  of 
the  unconscious  world  and  the  thorough  investiga- 
tion of  it  in  all  directions.  In  making  a  comparison 
of  the  earlier  works  concerning  this  unconscious 
world,  it  is  soon  noticeable  that  to  the  investigator 
it  was  the  great  mystery,  out  of  which  peculiar  phe- 
nomena such  as  automatic  writing,  the  speaking 
with  tongues,  etc.,  broke  forth  into  consciousness 
and  were  thus  made  approachable  for  research. 
Psychanalysis  is  the  unveiling  of  the  mystery.  The 
analyst  strives  to  find  the  connection  between  the 
unconscious  forces  and  the  shaping  of  life  in  general. 
In  an  educational  way,  his  goal  is  nothing  less  than 
to  make  free  the  individual  from  all  that  obscurity 
and  uncertainty  which  entangles  his  life. 

The  opposition  which  the  ordinary  psychanaly- 
tical  results  of  research  awaken  at  first  acquaint- 
ance, may  ver}r  largely  depend  upon  the  difficulty  of 


118      History  and  Practice  of  Psychanalysis 

keeping  in  mind  that  they  concern  unconscious  con- 
ditions. If  a  person,  who  neither  in  thought  nor  in 
action  is  guilty  of  misdemeanor,  should  be  accused 
for  example,  of  being  homosexual,  it  would  seem  in- 
famous. But  it  takes  on  quite  another  aspect  if  the 
accusation  only  implies  that  in  the  depths  of  the 
unconscious  life,  there  exists  a  difficulty  in  freeing 
the  sexual  life  from  the  sex  of  the  person  in  question, 
a  difficulty  which,  in  a  very  roundabout  way,  has 
come  into  the  consciousness  in  the  form  of  attacks 
of  anxiety,  the  connection  of  which  with  the  sexual 
life,  neither  the  patient  himself  nor  his  friends  have 
in  the  slightest  degree  suspected.  Before  Freud's 
declaration  that  the  child  is  a  polymorphic  pervert, 
everyone  shrinks  back  as  from  a  horrible  attack  upon 
the  much  prized  innocence  of  childhood.  But  noth- 
ing hinders  a  child,  so  far  as  its  consciousness 
reaches,  from  being  lovable,  well  brought  up,  free 
from  any  exhibition  of  sexuality  in  the  usual  mean- 
ing of  the  word  and  yet  analysis  may  nevertheless 
show  traces  of  polymorphic  perversity  in  the  depths 
of  the  unconscious  mind.  Far  more  offensive  than 
such  declarations  in  themselves,  I  consider  the  scien- 
tific light-mindedness  with  which  they  are  sometimes 
given  out.  In  reading  over  the  literature  on  this 
subject,  one  not  infrequently  is  amazed  at  the  rash- 
ness with  which  so-called  authorities  proclaim,  that 
behind  this  and  that  conscious  product  must  be  hid- 
den, this  or  that  unconscious  circumstance.  It  is 


Science  and  Method  of  Treatment        119 

true  that  in  psychanalysis  it  is  very  hard  always 
to  drag  along  the  proof-material  one  has  at  hand; 
on  this  account  a  better  idea  of  responsibility  is  ob- 
tained through  personal  discussion  than  through  the 
literature.  But  it  surely  would  be  beneficial  to 
science  if  more  careful,  slower  consideration  were 
accorded  the  subject. 

It  is  necessary  to  rightly  comprehend  the  method 
with  all  its  peculiarities,  defects  and  merits,  before 
making  an  estimation  of  the  doctrines  of  psych- 
analysis.  Because  those  are,  (and  this  fact  cannot 
be  too  strongly  emphasized),  no  theories,  but  the 
method's  direct  empirical  result.  In  order  not  to  be 
overwhelmed  by  their  many  changing  forms  and  con- 
stantly growing  mass,  I  shall  touch  only  upon  some 
single  and  relatively  settled  points. 


As  has  been  said  already  the  system  arose  in  con- 
nection with  the  study  of  the  mechanism  of  repres- 
sion. Its  further  development  and  application  have 
also  primarily  dealt  with  this.  This  has,  however, 
led  to  the  discovery  of  a  number  of  other  psychic- 
mechanisms,  which  have  importance  in  the  construc- 
tion of  neurosis  and  appear  to  be  fruitful  for  the 
study  of  the  subject. 

The  technical  term  used  to  signify  the  psychic 
material  which  differs  from  repression  is,  as  I  have 


120      History  and  Practice  of  Psycli  analysis 

said,  complex.  Further  study  has  to  do  with  the 
structure  of  complexes.  Just  as  the  conscious  af- 
fect in  a  certain  degree  is  a  psychic  principle  of  con- 
struction, in  that  it  directs  the  attention  toward  a 
decided  point,  gathers  to  itself  associations  from 
some  sources,  with  the  passing  over  of  others,  so  the 
repressed  affect  from  the  conscious  mind  may  be  the 
starting  point  for  psychic  productions.  In  the 
course  of  passing  years,  far  reaching  changes  occur 
in  this  way. 

Freud  considers  that  the  characteristics  for  hys- 
teria lie  in  the  fact  that  the  repression  had  its  place 
farther  back  in  life  and  underwent  changes  before 
it  became  constituted  as  a  disease.  He  separates 
therefrom  those  conditions  in  which  the  patient 
reacts  with  nervous  symptoms  against  an  actual 
checking  of  the  sexual  relief.  Through  analytical 
research  it  has  thus  come  to  light,  that  the  starting 
point  for  a  neurosis  may  be  far  removed  from  its 
point  of  out-break  and  that  the  original  injury  may 
be  so  widely  separated  from  the  neurotic  symtoma- 
tology,  that  no  one  before-hand  can  suspect  the  con- 
nection. In  traumatic  neurosis  the  chain  of  circum- 
stances between  the  trauma  and  the  nervous  symp- 
toms are,  as  a  rule,  obvious.  But  if  the  trauma  lies 
twenty  years  back  and  psychically  changes  during 
the  stress  of  this  period's  mental-stratification,  the 
causation  threads  may  be  a  very  much  entangled 
skein.  It  is  one  of  Freud's  greatest  merits  that  he 


Science  and  Method  of  Treatment        121 

has    succeeded   in   bringing   about   the   first   effort 
toward  the  disentanglement  of  this  skein. 

In  beginning  the  examination  of  a  neurotic,  it  is 
soon  noticeable  that  the  trouble  did  not  originate 
according  to  the  manner  in  which  the  patient  first 
makes  explanation  of  it.  Every  symptom  has  had 
some  prior  disturbance  upon  which  it  has  taken  hold. 
Disease  must,  like  everything  else,  have  some  founda- 
tion upon  which  to  build ;  otherwise  every  attempt  at 
construction  would  collapse.  Suppose  as  an  exam- 
ple that  a  person  is  exposed  to  some  affect  which 
makes  him  a  victim  to  insomnia.  As  soon  as  the 
affect  disappears,  sleep  again  returns ;  the  disturb- 
ance cannot  constitute  itself  as  an  illness  unless  it 
can  revive  the  hidden  traces  of  an  earlier  disturbance 
and  add  itself  to  these.  It  may  seem  as  if  the  step 
were  a  very  long  one  from  such  an  experience  as 
this  to  Freud's  categorical  sentence:  "All  neuroses 
have  their  foundations  laid  before  the  fifth  year  of 
life."  Nevertheless  there  may  be  much  truth  in  his 
opinion.  It  seems  very  probable  that  life  must  al- 
ready in  the  earliest  years  of  childhood,  have  been 
misdirected,  if  one  later  on  becomes  a  victim  to 
serious  neurosis.  However  this  does  not  mean  as 
much  as  it  may  appear  to  mean.  There  are  surely 
not  many  children  who  escape  injuries  and  conflicts 
and  yet  whose  lives  from  the  beginning  take  the  right 
track.  And  naturally  Freud's  proposition  must  not 
be  turned  around.  By  far  the  greater  number  of 


History  and  Practice  of  Psych-analysis 

infantile  injuries  are  compensated  for  during  de- 
velopment or  at  least  remain  somnolent,  unless  they 
are  brought  to  life  again  by  later  deep-seated  suffer- 
ing. 

For  the  sake  of  greater  clearness  it  may  be  suitable 
to  illustrate  the  connection  between  infantile  trauma 
and  neurosis  with  an  example.  I  shall  choose  one 
which  has  the  advantage  of  being  schematically  sim- 
ple. 

I  was  once  consulted  by  an  unmarried  woman 
of  twenty-two  years  of  age.  She  looked  well  and  had 
no  appearance  of  hysteria  in  the  usual  meaning  of 
the  word.  She  complained  of  a  series  of  nervous 
symptoms;  general  restlessness,  at  times  amounting 
to  anxiety,  especially  connected  with  thoughts  con- 
cerning her  heart  which  she  feared  would  suddenly 
stop  beating, — the  attacks  coming  on  with  lack 
of  breath  and  strangling, — choking  feeling  in  the 
throat;  after  eating  she  was  overcome  by  a  painful 
sensation  of  heat  in  the  whole  body  which  lasted  for 
hours  at  a  stretch;  difficulty  in  walking  any  dis- 
tance,— as  her  legs  gave  way  beneath  her  so  that  she 
was  obliged  to  quickly  board  a  street-car  in  order  to 
get  home.  Regarding  the  origin  of  these  symptoms 
she  knew  nothing  more  than  that  two  years  before 
she  had  been  to  the  theatre  with  a  cousin  and  was 
there  suddenly  overcome  by  a  feeling  of  suffocation. 
Since  then  the  symptoms  had  accumulated  one  after 
the  other.  All  inquiries  after  further  causation  were 


Science  and  Method  of  Treatment 

fruitless.  All  treatment  had  been,  hitherto,  unsuc- 
cessful. 

The  result  of  the  analysis  was  as  follows: — when 
the  patient  was  between  four  and  five  years  old, 
her  family  dwelt  in  the  fourth  story  of  a  house  in 
the  city.  One  afternoon  there  was  an  explosion,  fire 
broke  out  on  the  ground  floor  and  spread  terror 
through  the  whole  house.  The  smoke  forced  itself 
up  the  stairway.  The  patient  remembers  how  her 
father  carried  her  out  upon  the  stairs  and  kicked 
out  a  pane  of  glass  that,  they  might  not  be  smothered 
by  the  smoke. 

In  realizing  how  a  sensitive  child  reacts  from  such 
a  shock,  it  is  easy  to  see  that  the  patient's  whole 
symptom-complex  is  nothing  but  a  reproduction  of 
this  experience.  The  fear  of  strangling,  the  breath- 
lessness,  the  choking,  the  attacks  of  heat, — every- 
thing is  a  direct  copy.  The  shock  also  had  had  a 
paralyzing  effect,  so  that  her  legs  gave  way  under 
her.  The  fact  that  the  father  carried  her,  perhaps 
also  had  been  brought  in,  to  suggest  the  feeling  that 
she  could  not  walk. 

How  is  one  now  to  be  sure  that  such  interpreta- 
tion is  right?  In  the  first  place  the  patient  recog- 
nized the  connections.  She  experienced  a  feeling 
of  relaxation  similar  to  that  one  has  if  one  has  for- 
gotten a  word  and  then  suddenly  recalls  it.  In  the 
second  place  I  was  able  to  find  a  whole  series  of 
symptoms  and  accidental  sensations  to  which  the 


124      History  and  Practice  of  Psyclianalysis 

patient  attached  little  importance,  but  which  proved 
that  this  childhood  trauma  had  lead  up  to  the  con- 
dition of  illness.  In  the  third  and  most  important 
place;  ex  juvantibus.  Simultaneously  with  this 
clearing  up  of  the  past,  the  symptoms  underwent 
an  important  change.  They  diminished  or  entirely 
disappeared;  even  if  a  few  continued  to  be  recalled, 
they  had  not  the  same  power  over  her,  but  were 
looked  upon  by  her  as  mere  unimportant  matters. 

The  significance  of  the  origin  of  this  neurosis, 
must  not  however  be  exaggerated.  Underneath  it 
very  probably,  lay  still  deeper  infantile  sources  and 
it  is  certain  that  during  adolescence  injuries  had 
been  added,  due  to  which,  the  already  suggested 
shock  was  able  to  bring  about  the  neurotic  condition. 
In  the  investigation  of  these  things,  we  must  always 
come  into  touch  with  the  most  intimate  life  of  the 
patient  and  that  this  must  be  handled  with  the 
greatest  delicacy  of  feeling  is  self-evident.  The 
youth  of  this  patient  had  been  made  unhappy  be- 
cause of  her  father's  infidelity  to  her  mother,  con- 
cerning which,  just  at  the  time  of  the  outbreak  of 
the  neurosis,  she  had  become  fully  aware.  At  this 
outbreak,  there  occurred  accidentally  a  union  of 
this  source  with  that  derived  from  childhood.  Upon 
the  evening  in  question  at  the  theatre,  the  patient 
had  seen  Ibsen's  "Ghosts."  No  play  can  be  more 
suited  to  stir  up  the  despair  of  a  young  girl  over 
the  infidelity  and  frivolity  of  a  father.  When  I  now 


Science  and  Method  of  Treatment         125 

asked  at  what  part  in  the  play  she  had  had  her 
first  attack,  she  burst  into  a  hearty  laugh,  as  if  in 
relief  at  seeing  some  clear  light  ahead.  She  plainly 
recalled  that  it  was  at  that  part  where  the  fire  ac- 
cident is  spoken  of.  The  theme  of  the  play  itself 
had  thus  set  the  patient's  own  suffering  in  a  quiver, 
causing  a  mental  tension  of  such  force  that  it  had  to 
have  outlet.  When  therefore  came  a  cue  which, 
through  associations,  disrupted  those  nervous  sen- 
sations originating  from  the  fire-complex,  the  strain 
broke  out  on  the  path  already  staked  out  for  it  and 
converted  this  at  the  same  time,  into  a  channel  for 
suffering;  every  new  strain  was  thus  converted  in  a 
similar  way, — that  is  to  say,  it  sought  an  outlet  on 
the  road  of  least  resistance.  Instead  of  for  example, 
being  accompanied  now  by  sorrow  and  repulsion, 
every  meeting  with  her  father  was  followed  by  an 
attack,  such  as  has  been  described  in  the  symptom- 
atology of  the  case. 

The  construction  of  the  neurosis  had  surely  not 
come  about  so  simply  as  it  appears  from  this  descrip- 
tion. Just  as  behind  the  childhood-trauma  might 
have  been  found  a  deeper  source  for  it,  so  behind 
the  experience  during  adolescence,  might  the  same 
thing  have  been  discovered.  The  determining  im- 
portance of  this  fact  is  obtained  at  the  instant  when 
these  experiences  could  be  connected  with  the  pa- 
tient's own  inner  conflicts.  Freud  believes  that  back 
of  every  neurosis,  without  a  single  exception,  lies  the 


126      History  and  Practice  of  Psychanalysi* 

sexual-life ;  that  this  is  the  only  real  producing  force 
in  life;  that  without  the  assistance  of  its  piled-up 
energy,  no  circumstance  could  cause  permanent  dis- 
turbance of  the  soul-life  or  of  the  nervous  system. 
The  patient  returned  to  me  some  months  after  the 
treatment  which  I  gave  her,  complaining  of  a  con- 
dition of  general  restlessness.  She  herself  under- 
stood, or  at  any  rate  suspected,  the  connection  of 
this  restlessness  with  a  restraint  of  the  course  of 
her  sexual-life;  she  had  been  engaged  to  be  married 
for  some  months  but  there  was  no  prospect  of  the 
marriage  taking  place  for  years  to  come.  I  had  no 
doubt  that  these  facts  had  a  determining  value  in 
regard  to  the  return  of  the  hysterical  symptoms. 

It  is  not  possible  to  understand  Freud's  asser- 
tion of  the  great  importance  of  the  sexual  life  in  the 
building  up  of  neuroses,  without  first  having  a  com- 
prehension of  his  sexual  doctrine  in  its  whole  mean- 
ing. 

Freud  believes  that  sexual  impulses  originally  arise 
through  the  spontaneous  yearning  back  of  the  child 
to  the  mother-body  from  which  it  came. 

No  doubt  most  of  those  to  whom  this  cardinal 
proposition  is  new,  are  at  once  ready  to  condemn 
the  whole  doctrine  as  an  absurdity.  It  can  surely 
not  be  his  meaning  that  the  sexual-life  itself  has  its 
root  in  an  incestuous  impulse  which  we  are  accus- 
tomed to  consider  as  the  extreme  of  sexual  path- 
ology! Nevertheless  that  is  what  he  means.  In 


Science  and  Method  of  Treatment         127 

passing  I  may  mention  that  I  have  discovered  a  pre- 
decessor of  Freud's  in  this  dreadful  modern  idea. 
Our  great  master,  Luther,  who  in  matters  sexual 
was  a  man  extraordinarily  experienced,  expresses 
himself  in  Chap.  20,  §  27  in  Tischreden :  "So  wenig 
man  des  Essens  und  Trinkens  entbehren  und  gera- 
then  kann,  so  unmoglich  ist  es  auch,  sich  von  Weibern 
zu  enthalten:  denn  wir  ko'nnen  durch  natiirliche 
Begierde  allermassen  uns  nicht  davon  entaussern. 
Die  Ursache  ist,  dass  wir  in  die  Weiber  Leibe  empf  an- 
gen,  darinnen  ernahrt,  davon  geboren,  gezeugt  und 
erzogen  werden,  also,  dass  unser  Fleisch  das  meiste 
Theil  Weiberfleisch  ist,  und  ist  unmoglich  uns  von 
ihnen  ganz  abzusondern." 

In  this  utterance  is  already  found  the  connection 
between  the  sexual-life  of  the  adult  and  all  that 
sphere  of  phenomena  which  concerns  the  child's  orig- 
inal connection  in  regard  to  the  mother.  It  is  here 
that  the  center  of  gravity  of  Freud's  sexual  doctrine 
lies.  According  to  Luther,  the  impulse  has  its  cause 
in  the  fact  that,  figuratively  speaking,  we  are  never 
able  to  entirely  cut  off  the  navel-string.  For  Freud 
this  prolonged  resolvent  of  the  bodily  connection  and 
all  the  complications  that  may  arise  therefrom,  plays 
a  dominating  role. 

The  intense  longing  of  the  child  for  the  mother, 
its  anxiety  in  the  mother's  absence,  its  refusal  to 
sleep  if  it  cannot  rest  in  the  mother's  arms,  etc., — 
all  these  features  which  with  the  new-born  always 


128      History  and  Practice  of  Psychanalysis 

crop  up,  are  thus  an  expression  of  the  primary 
sexual-life.  Over  the  abyss  which  separates  this  from 
the  turbulent  longing  of  the  man  and  the  woman 
for  each  other,  Freud  has  thrown  the  bridge  of 
sexual  development.  I  must  limit  myself  to  a 
schematic  description  of  the  most  significant  steps 
upon  this  bridge. 

The  first  attempt  toward  disentanglement  from 
the  mother  occurs  when  the  child  teaches  itself  to 
give  way  on  its  own  account  to  those  pleasurable 
sensations,  which  hitherto  it  has  felt  only  in  con- 
nection with  the  mother's  body;  when  e.  g.  it  sticks 
its  thumb  into  its  mouth  in  place  of  the  nipple  and 
so  learns  to  go  to  sleep  alone.  Through  this  act  the 
ground  is  broken  for  that  phenomenon,  for  which 
Freud  accepted  Havelock  Ellis'  term  "autoerotism." 
Under  this  caption  are  gathered  together  all  efforts 
to  set  free  sensations  of  pleasure,  with  the  assistance 
of  the  own  body.  This  occurs  in  many  different 
ways.  Freud  has  especially  pointed  out  the  im- 
portance of  the  anal  region  in  this  respect  and 
created  that  esthetically  extraordinarily  revolting 
idea  of  the  analerotic.  For  the  child  everything  it 
discovers  and  every  new  sensation,  has  interest.  In 
its  unconscious  innocence  it  defines  nothing,  as  an 
adult  does.  That  the  anal  function  as  a  source  of 
pleasure  with  children  is  often  much  accentuated, 
is  something  that  has  come  to  the  notice  of  many  who 


Science  and  Method  of  Treatment         129 

have  had  to  do  with  children.  And  that  a  false  syn- 
thesis may  be  formed  between  this  source  of  pleasure 
and  the  sexual  sources,  is  not  astonishing  if  the  close 
bodily  connection  of  the  organs  is  considered — it 
means  only  a  psychic  analogy  to  the  physical  fact. 
It  is  also  indubitable  that  in  neurosis  one  meets  rela- 
tively often  with  such  a  synthesis  existing  from  the 
childhood  and  that  it  plays  a  certain  part,  not  only 
in  the  formation  of  symptoms,  but  also  in  the  devel- 
opment of  character.  There  is  some  truth  in  Freud's 
opinion  that  certain  features  of  character  may  be 
taken  as  reactions  against  this  disturbance.  The  hot 
attack  to  which  Freud  was  subjected  on  account  of 
his  doctrines  regarding  analerotism  may  perhaps  in 
a  measure  be  authorized.  He  makes  himself  guilty 
of  some  exaggeration.  But  on  the  other  hand  this 
attack  against  him  was  made  very  largely  because 
he  touched  upon  an  especially  sensitive  point  in  the 
emotional  life.  The  question  may  be  raised,  if  just 
this  contact  between  the  lowest  impulses,  the  most 
material  sphere,  and  that  other  sphere  in  which  our 
highest,  most  sublime  emotions  are  bound  up,  is  not 
one  of  the  foundations  for  man's  burdensome  feeling 
of  being  earth-bound.  Does  not  all  talk  of  the  erotic 
as  something  foul,  originate  through  a  lack  of  under- 
standing of  this  tragedy?  Whatever  may  be  said 
about  Freud's  position  in  the  question,  it  will  al- 
ways be  counted  to  his  credit,  that  he  did  not  hesi- 


130      History  and  Practice  of  Psyclianalysis 

tate  to  present,  with  indomitable  scientific  honesty, 
what  he  believed  he  had  discovered  in  this  appalling 
abyss  of  the  psychic  life. 

The  first  step  toward  disentanglement  from  auto- 
erotism  is  taken  when  the  individual  begins  to  search 
after  an  external  object,  with  the  help  of  which  the 
sexual  forces  may  be  outwardly  projected.  That  a 
strong  attraction  to  the  opposite  sex  may  arise  dur- 
ing early  life  is  well  known.  But  usually  only  cer- 
tain phases  of  development  can  be  traced  before  the 
hetero-sexual  pursuit  becomes  of  chief  importance. 
The  sexual-life  first  seizes  what  lies  nearest  at  hand, 
— that  is  to  say,  the  general  objectification  of  the 
own  personality  in  the  ego.  This  period  is  called 
"narcissism."  It  reveals  itself  consciously  through 
the  flaming  up  of  the  "I"  complex,  that  overestima- 
tion  of  self,  that  loss  of  consideration  for  others, 
that  is  characteristically  woven  into  the  critical 
period  of  youth. 

The  next  step  makes  an  attempt  to  compensate 
this  objectification  of  self  with  an  unfamiliar  person. 
There  is  still  shyness  and  backwardness  between  the 
sexes,  but  there  is  the  beginning  of  the  feeling  of  ad- 
miration in  the  being  together  with  comrades.  Ex- 
ternally the  sexual  undercurrent  reveals  itself 
through  enthusiastic  admiration  of  friends,  teachers 
and  so  on. 

Puberty  here  first  comes  upon  that  great  revolu- 
tion through  which  the  infantile  sexual  sources  are 


Science  and  Method  of  Treatment         131 

gathered  together  into  one  single  channel,  and  life 
takes  on  definite  form ;  all  sensations  of  pleasure,  all 
emotional  inclination  to  over-estimate,  all  enthusias- 
tic devotion,  is  bound  up  in  the  opposite  sex. 

Hand  in  hand  with  this  development  proceed  three 
processes  of  basic  importance: — repression,  trans- 
ference, sublimation.  Each  change  occurs  because 
the  individual  represses  the  dominating  sexual  form, 
transfers  the  sexual  impulses  to  a  new  object  and 
changes  a  part  of  them  to  a  source  of  energy  for 
remote  cultural  purposes. 

That  sexual  development  is  the  hardest  test  for  a 
human  being  must  indeed  be  considered  a  universally 
accepted  truth.  Looked  at  from  this  point  of  view 
an  answer  as  to  why  conditions  are  as  they  are,  is 
given.  The  enormous  unconscious  work  each  one  must 
accomplish  in  order  to  lead  unfoldment  toward  its 
goal,  is  then  understood,  as  well  as  what  danger  there 
is  that  all  this  work  may  go  astray.  The  danger  lies 
not  only  in  the  fact  that  the  repression  may  thus 
fix  upon  one  or  another  perversity ;  it  also  lies  in  the 
fact  that  the  individual  in  this  struggle  must  use 
up  so  large  a  part  of  his  forces,  that  little  power 
remains  for  the  rest  of  life.  The  most  common  dis- 
turbances arise  because  of  partial  failure.  The  re- 
pression appears  to  be  carried  out,  but  it  is  so  weak- 
ly organized  that  it  again  works  loose  because  of 
conditions  from  without,  which  threaten  to  break 
through;  the  individual  must  time  after  time  assem- 


132      History  and  Practice  of  Psychanalysis 

ble  his  forces  in  order  to  reinforce  them.  It  may 
perhaps,  without  exaggeration,  be  said,  that  unfold- 
ment  never  comes  about  in  an  ideal  way.  In  each 
one  is  left  some  unhealed  wound,  some  weak  point. 
Only  the  very  strong  reach  a  point  where  the  im- 
pulses are  centralized  and  that  entire  emancipation 
which  is  the  final  goal.  And  what  here  gives  aid  is  a 
constitutional  transcendency  in  transference  and 
sublimation.  On  the  other  hand  it  is  lack  of  these 
qualities  that  above  all  are  distinguishing  marks  in 
the  weak  and  that  more  than  anything  else  pre- 
destines them  to  insanity. 

According  to  Freud,  one  always  in  analysis  comes 
upon  some  disturbance  of  the  sexual  unfoldment 
which  is  the  nucleus  of  the  complex.  The  farther  the 
analysis  is  carried,  just  so  much  more  established 
becomes  the  fact  that  the  disturbance  is  one  of  pri- 
mary sexuality.  He  has  even  declared  that  the  most 
remote  thread  may  always  be  traced  back  to  the  orig- 
inal incestuous  desire,  and  he  has  therefore  called 
this  the  nucleus  complex  of  neurosis. 

It  would  thus  appear  that  neuroses  in  their  deep- 
est state  of  existence  ought  to  be  built  up  of  pretty 
much  the  same  material.  The  great,  apparent  fer- 
tility of  variation  in  them,  might  thus  arise  because 
similar  complexes  grow  out  in  different  ways  accord- 
ing to  individuality  and  contingencies,  before  they 
acquire  conscious  formation.  Upon  the  basis  of  this 
opinion  Freud  has  also  tried  to  work  out  the  symp- 


Science  and  Method  of  Treatment         183 

tomatology  of  neuroses.  Earlier,  when  the  sexual 
trauma  of  childhood  held  his  special  interest,  he 
probed  the  doctrine  that  the  passive  experience — 
seduction, — led  to  hysteria — the  active  experience — 
i.  e.  the  aggression — to  compulsion-neuroses.  He 
tried  in  this  way  to  explain  why  hysteria  is  more 
usual  among  women,  compulsion-neuroses  among 
men.  He  wished  to  make  probable  that  the  libidinous 
fixation  upon  a  certain  point  of  the  scale  of  un- 
foldment  led  to  a  certain  form  of  disease.  If  the 
individual  does  not  succeed  in  lifting  himself  out  of 
autoerotism,  or  if  he  uses  up  all  his  vitality  in  the 
struggle  against  it,  a  blockade  from  without  takes 
place,  because  it  is  chiefly  through  the  projecting  of 
the  sexuality  outwards,  that  we  learn  to  direct  our 
forces  towards  the  external  world;  thus  the  unsuc- 
cessful individual  is  doomed  to  burn  up  these  forces 
within  himself — ;  the  final  result  being  dementia. 
This  is  only  a  hint  of  that  remodelling  of  diagnoses, 
which  more  profound  insight  into  functional  disease 
processes  may  finally  carry  with  it. 

If  this  sexual  teaching  is  true,  we  should  here 
stand  before  the  disclosure  of  something  so  fearful, 
that  a  parallel  has  hitherto  surely  never  been  found 
in  the  development  of  human  knowledge.  Thus  each 
one  who  is  born  possesses,  according  to  nature's 
own  order,  in-dwelling  powers,  which  may  cast  him 
into  crime,  perversity,  insanity  and  nervous  suffer- 
ing, unless,  after  a  struggle  of  decades,  he  succeeded 


134      History  and  Practice  of  Psychanalysis 

in  becoming  master.  And  in  case  he  does  succeed, 
he  nevertheless  wanders  upon  a  thin  crust  of  earth, 
over  volcanic  forces,  which,  under  unfavorable  con- 
ditions, may  give  way  and  undo  all  the  work  he  had 
accomplished.  Is  it  strange  that  the  whole  world 
of  learning  hurled  anathema  upon  the  author  of  such 
a  doctrine? 

I  shall  point  out  in  passing  that  a  kind  of  inkling 
of  this  same  idea  has,  however,  been  buried  in  the 
folk-consciousness,  from  very  ancient  times.  It  is 
most  plainly  traceable  in  tragic  poetry.  Freud  has 
done  nothing  but  take  the  scientific  road  to  the  same 
goal,  which  in  former  times  was  taken  by  intuition, 
self-analysis,  and  fantasy.  I  shall  give  the  most  com- 
mon example  of  this. 

The  nucleus  complex  of  neurosis  in  the  literature, 
also  is  given  the  name  CEdipus-complex,  because  this 
old  tragedy  is  only  a  plastic  presentation  of  the 
incestuous  primary  impulse  and  the  succumbing  of 
the  hero  to  it.  As  is  well  known,  the  circumstances 
are  as  follows : 

Laius,  King  of  Thebes,  was  expecting  a  child  by  his 
Queen,  Jocasta.  The  oracle  was  consulted  concern- 
ing this  event.  The  answer  given  was  that  the  child 
must  be  exposed  to  the  elements  as  otherwise  he 
would  grow  up  to  murder  his  father  and  marry  his 
mother.  As  soon  as  CEdipus  was  born,  he  was  thus 
exposed.  But  his  life  was  saved  by  a  chance  and 
he  was  brought  up  at  a  foreign  court.  When  he  was 


Science  and  Method  of  Treatment         135 

grown,  he  started  out  upon  a  wandering  journey, 
was  attracted  toward  Thebes,  and  upon  the  road  fell 
in  with  a  man,  with  whom  he  picked  a  quarrel  and 
whom  he,  as  a  consequence,  murdered.  This  man 
was  Laius.  (Edipus  went  on  to  Thebes,  succeeded  in 
solving  the  riddle  of  the  Sphinx,  and  was  proclaimed 
king  by  the  Thebans.  He  married  the  widow  of 
Laius,  his  own  mother.  A  pestilence  then  broke  out 
in  the  land,  and  when  questioned  as  to  what  should 
be  done,  the  oracle  replied  that  the  murderer  of 
Laius  should  be  traced  and  driven  away.  Thus  every- 
thing came  to  light.  In  despair  CEdipus  put  out  his 
eyes,  etc. 

Back  of  this  symbol  is  discovered  a  fearful  poten- 
tiality within  the  man,  CEdipus,  which  contrary  to 
all  human  actions  and  all  his  conscious  effort,  drove 
him  straight  to  a  certain  point.  This  power  has 
been  called  fate  and  the  meaning  of  the  tragedy  has 
been  considered  to  be  the  impotence  of  mankind 
against  fate.  But  analysis  removes  this  blind  com- 
pelling force,  from  the  sphere  of  the  external  world 
to  that  of  the  human  mind;  fate  is  nothing  but  the 
most  deeply  hidden  unconscious  complex.  CEdipus 
was  engulfed  in  it  because  he  neither  succeeded  in 
forcing  it  so  deep  down  into  Orcus  that  its  power 
was  stifled,  nor  in  throwing  his  consciousness  about 
it  in  such  a  way  that  he  became  its  master. 

In  paying  close  attention  to  children,  it  is  some- 
times possible  to  discern  detached  remnants  of  this 


136      History  and  Practice  of  Psychanalysis 

motif  back  of  their  chatter  and  games.  It  is  not  so 
uncommon, — I  have  at  least  heard  several  examples 
of  it — that  a  small  boy  lets  something  like  this 
escape  him:  "When  I  am  big  I  am  going  to  marry 
mother."  And  if  anyone  then  explains  that  such  a 
thing  will  be  impossible  because  father  is  already 
married  to  mother,  the  answer  very  often  will  be: 
"Then  I  shall  kill  father!"  The  child  does  not  ap- 
preciate life  and  death  in  the  same  way  we  do.  It 
looks  upon  these  things  rather  as  our  earliest  an- 
cestors did.  "Out  of  the  way"  it  shouts  from  the 
saddle  of  its  rocking  horse,  "or  I'll  ride  over  you !" 

As  a  rule  we  laugh  at  such  episodes  of  the  nursery. 
But  behind  them  may  lurk  complexes  with  which  the 
grown  boy  or  girl  must  fight,  and  which  later  on 
may  throw  a  shadow  over  the  whole  life, — break- 
ing out  at  last  perhaps,  in  the  form  of  neurotic 
symptoms. 

That  we  still  today  can  be  seized  by  the  CEdipus 
tragedy  and  react  to  it,  Freud  believes  to  be  depend- 
able upon  the  idea  that  it  touches  that  portion  of 
our  inner  selves,  which  in  spite  of  thousands  of  years 
of  repression  work,  cannot  be  wholly  brought  into 
a  state  of  rest. 

*         »          » 

Against  the  background  of  these  suggestions  con- 
cerning psychanalysis  as  a  science,  I  shall  now  at- 


Science  and  Method  of  Treatment         187 

tempt  to  indicate  a  few  of  the  most  valuable  thera- 
peutic points  of  view. 

Since,  where  science  was  concerned  it  showed  that, 
in  conformity  with  all  higher  psychology,  it  could 
not  free  itself  from  a  certain  subjective-artistic  qual- 
ity, so  this  must  be  all  the  more  pronounced  where 
therapy  is  concerned.  Psychotherapy  generally  is 
something  different  in  the  hands  of  every  physician, 
unless  he  limits  his  activity  to  dogmatic  plagiarizing 
from  some  predecessor.  Some  "authorities"  con- 
tinue to  totally  condemn  psychanalysis.  In  so  doing 
they  place  themselves  outside  the  development  of 
the  science  of  medicine.  Already  this  thing  has 
reached  a  point  where  each  one  must  reckon  with 
it,  just  as  with  suggestion.  The  question  is  then, 
where  and  how  it  should  be  installed  in  the  therapeu- 
tic procedure.  The  most  earnest  disciples  of  Freud 
are  entirely  taken  up  in  the  analysing;  for  those 
who  go  to  the  opposite  extreme,  psychanalysis  means 
only  a  throwing  aside  of  the  usually  accepted  form, 
and  an  effort  to  look  upon  case-histories  from  the 
patient's  own  standpoint ;  i.  e.  from  within.  Freud's 
enemies  are  not  likely  to  dispute  his  merit  in  teaching 
us  to  look  upon  neuroses  and  insanity  in  their  con- 
nection with  life  and  its  conflicts. 

As  has  been  said  before,  the  idea  of  abreaction 
was  originally  the  fundamental  principle  of  this 
therapy.  It  was  chiefly  the  developing  of  the  sexual 


138      History  and  Practice  of  Psychanalysis 

doctrine  that  brought  a  new  point  of  view  to  this 
method  of  treatment.  If  it  is  true  that  a  represented 
sexual  desire  always  lies  at  the  base  of  a  neurosis, 
how  then  can  any  psychic  treatment  at  all  be  taken 
into  consideration  ?  Even  if  a  clear  understanding  is 
to  be  preferred  to  all  that  tangle  of  lies  and  illu- 
sions, in  which  people  become  enmeshed  in  order  to 
escape  the  fact  of  sexuality,  this,  as  such,  does  not 
permit  itself  to  be  "abreacted."  It  is  very  easy  to 
suspect  that  analysts  might,  in  such  case,  choose  a 
way  out,  by  advising,  as  many  physicians  do  ad- 
vise, sexual  congress  at  any  and  all  times  as  a  cure 
for  neurosis.  It  is  indeed  possible  that  such  advice 
sometimes  is  given  by  analysts.  But  Freud  himself 
believes  that  advice  of  this  kind  very  seldom  may  be 
suitable.  He  cautions  against  what  he  calls  "wild 
analyzing"  and  holds  himself  strongly  aloof  from 
those  followers  of  his  teachings  who  offend  him  in 
this  respect.  For  my  own  part  I  believe  that  this 
brutal  simplification  of  the  problem  is  absolutely 
condemnable  from  a  therapeutic  point  of  view.  The 
sexual  act  is  relieving  only  if  it  is  called  forth  by  an 
inner  yearning,  and  if  it  is  accompanied  by  a  feeling 
of  joy, — not  if  it  is  practiced  by  command.  I  recall 
a  woman  of  twenty-one  years  of  age,  who  had  suf- 
fered for  six  years  from  a  nervous  disturbance  of  the 
bladder  and  who  was  advised  by  a  doctor  to  try  this 
means  of  relief.  She  came  to  a  colleague  after  a 
while,  this  time  afflicted  with  gonorrhea.  The  blad- 


Science  and  Method  of  Treatment         189 

der  trouble  had  become  plainly  more  pronounced. 
After  some  weeks  of  suggestive  treatment  it  entirely 
disappeared.  In  this  case  the  sexual  act  had  only 
been  a  shock,  as  it  may  often  be  under  similar  cir- 
cumstances. 

It  is  not  at  all  upon  the  gross  material  liberation 
of  the  sexual  impulses  that  relief  depends.  What 
essentially  brings  about  forms  of  neuroses  is  not 
direct  sexual  restraint ;  it  is  the  conflict  between  the 
inclination  and  the  inner  opposition,  that  stands  in 
the  way  of  freedom;  the  conflict  between  the  will  to 
love  and  the  incapacity  to  love.  As  long  as  this  in- 
ner opposition  exists,  every  physical  sexual  act  is 
only  something  more  overwhelming,  which  adds  to 
the  nervous  tension  and  becomes  manifested  in  neu- 
rotic symptoms.  This  opposition  is  often  a  psycho- 
logical product  that  is  accessible  for  analytical  dis- 
solution. There  is  thus  a  point  upon  which  the 
physician  may  apply  his  aid.  The  breaking  down 
of  inner  opposition  is  also  a  valuable  part  of  the 
treatment.  But  this  is  not  the  place  to  further  en- 
large upon  this  fact.  However  there  is  one  objec- 
tion which  is  often  made  upon  which  I  must  touch. 
The  very  word  "opposition"  arouses  in  many  people 
the  idea  of  compulsion,  and  they  look  upon  the  whole 
thing  as  if  it  were  some  form  of  spiritual  torture.  A 
psychologist  who  believes  that  psychic  opposition 
may  be  broken  by  means  of  harsh  treatment,  is  surely 
not  an  analyst.  Even  if  this  could  happen,  it  would 


140      History  and  Practice  of  Psychanalysis 

never  be  a  question  of  any  other  harshness  than  that 
which  was  in  accord  with  the  patient's  own  innermost 
desire.  One  patient  who  could  speak  of  himself  only 
with  the  greatest  difficulty,  begged  me  to  promise 
never  to  let  him  go  before  he  had  said  all  those 
things  which  he  was  incapable  of  saying  by  him- 
self. 

But  this  inner  resolution  is  only  a  part.  Sup- 
posing it  is  successful,  the  forces  thus  made  free 
must  have  some  outlet  in  order  that  they  may  be 
prevented  from  again  turning  themselves  back 
towards  the  production  of  disease. 

In  speaking  about  the  sexual  unfoldment,  I  said 
that  it  goes  hand  in  hand  with  three  psychological 
processes,  viz :  repression,  transference,  and  sublima- 
tion. Upon  the  first  of  these  the  ordinary  sugges- 
tion-treatment gets  in  its  work.  This  means  often 
only  a  support  of  the  normal  repression,  so  that  it 
may  become  successful.  The  patient  may  thus  be 
able  to  force  away  thought-pictures,  forget  sorrows, 
concentrate  the  mind  upon  work,  etc. 

Freud  places  the  therapeutic  center  of  gravity 
upon  the  second  point.  All  psychological  curative 
action  takes  place  through  transference,  according 
to  his  belief.  The  cramped  and  erring  sexual  im- 
pulses must  be  carried  over  upon  new  objects.  Oth- 
ers believe  that  all  psychic  treatment  ought  to  be 
concentrated  upon  the  last  point — sublimation.  The 
sexual-life  can  not  be  definitely  forced  back ;  its  di- 


Science  and  Method  of  Treatment         141 

rect  liberation  can  occur  only  through  circumstances 
of  life  which  lie  outside  the  physicians'  field  of  ac- 
tion. The  only  way  in  which  the  individual,  inde- 
pendent of  outside  conditions,  can  save  himself,  is 
through  turning  his  forces  toward  cultural  ends. 

The  simplest  and  purest  form  of  sublimation  is 
poetry.  Its  connection  with  the  deepest  of  earthly 
forces  has  indeed,  been  well  known  in  all  times.  What 
poets  do, — that  is  to  say,  what  those  who  write 
because  some  power  within  drives  them  to  it, — is 
only  to  bring  repressed  desires  to  light  by  means 
of  self-analysis,  and  to  make  them  sublime  in 
thoughts,»dramatic  figures,  legendary  symbols,  etc. 

Sophocles  was  able  through  some  such  process  to 
free  himself  from  his  (Edipus-complex.  If  we,  as 
physicians,  are  consulted  by  an  individual,  who  is 
about  to  give  way  before  some  unconscious  force,  it 
is  our  duty  to  help  that  one  to  some  similar  kind  of 
inner  redemption.  Naturally  we  can  not  make  every 
one  a  poet  in  the  usual  meaning,  but  the  rescue  may 
be  brought  about  in  many  ways.  In  poetry  the  com- 
plexes are  transplanted  directly  to  an  external  work, 
which  gives  a  clear  vision  and  upon  which  the  pas- 
sions, so  made  free,  are  directly  transferred.  This 
combination  is  certainly  not  a  necessity.  The  ex- 
ternal labor  may  be  of  any  kind  suited  to  the  indi- 
vidual. Thus  analytical  treatment  and  the  thera- 
peutics of  work,  here  form  a  point  of  contact.  A 
clear  out-look  is  obtained  through  conversation  with 


History  and  Practice  of  Psychanalysts 

the  analyst.  As  to  the  passions  which  have  been 
made  free,  they  should  as  directly  as  possible  seek 
a  natural  outlet.  The  analytical  disentanglement 
should  so  work  out  that  the  patient's  love  may  be- 
come stronger  than  ever  for  all  that  he  has  once  loved 
before;  thus  a  married  woman  may,  with  renewed 
earnestness,  turn  to  the  guardianship  of  her  home, 
her  children,  etc. 

With  this  treatment  therefore,  the  effort  is  one  of 
instructing  the  patient  regarding  the  freedom  of  the 
inner-self, — the  difficult  art  of  spiritual  emancipa- 
tion. The  part  here  played  by  the  personality  of 
the  analyst  ought  to  be  the  same  as  that  played  by 
instructors  in  general. 


Medical  research  has  its  greatest  importance  in 
the  fact,  that  because  of  added  knowledge  concern- 
ing the  inception  of  disease,  we  are  able  to  take  means 
towards  its  prevention.  In  single,  fully  developed 
cases,  conditions  are  often  such  that  no  retracing  of 
steps  is  possible.  But  by  obtaining  accurate  infor- 
mation about  such  cases  we  may  perhaps  prevent  a 
similar  state  in  some  other  individual.  This  is  par- 
ticularly true  in  the  research  of  psychanalysis.  The 
prophylactic  hope  it  awakens  is  of  several  kinds. 

If,  as  Freud  believes,  a  great  many  neurotic 
symptoms  are  only  sexual  symbols,  through  which 
patients  procure  for  themselves  a  kind  of  freedom 


Science  and  Method  of  Treatment         145 

from  suffering,  the  symptoms  must  disappear  with 
the  unveiling  of  the  condition.  Freud  points  out 
that  we  have  seen  something  like  this  in  the  Madonna- 
hallucinations  of  Roman  Catholic  countries.  A» 
long  as  people  generally  credited  the  reality  of  these 
visions  they  were  common;  when  the  phenomenon  is 
now  put  under  the  rubic  of  hysteria  it  has  lost  it? 
value  and  disappeared; — the  way  for  the  outlet  of 
the  unconscious  forces  is  thus  destroyed.  Naturally 
the  suffering  itself  does  not  disappear,  but  only  that 
form  of  it  capable  of  being  explained. 

Application  of  these  new  experiences  to  pedagog- 
ics, seems  to  be  more  momentous.  Now  that  it  p» 
shown  that  neurosis  begins  in  childhood,  it  must 
become  one  of  the  first  duties,  in  the  bringing-up 
of  the  child,  to  keep  it  free  from  the  mass  of  injurious 
influences,  the  import  of  which  hitherto  has  not  been 
estimated.  For  example  a  woman  of  forty-seven 
years  came  to  me,  who  had  suffered  periodically  from 
insomnia  during  her  whole  life.  As  a  little  child 
she  had  wakened  in  the  night  in  terror  and  could  not 
again  go  to  sleep,  unless  she  was  allowed  to  creep 
into  her  sister's  bed.  Here  insomnia  was  founded 
because  the  child  was  not  taught  from  the  very  start 
to  sleep  alone, — and  this  mistake  had  never  after- 
wards been  rectified.  When  she  came  to  me,  the  last 
period  had  lasted  without  relief  for  the  three  years 
during  which  she  had  been  a  widow.  In  the  constant 
contact  with  such  circumstances,  which  easily  might 


144      History  and  Practice  of  Psychanalyris 

have  been  changed  in  childhood,  it  is  not  possible  to 
avoid  the  feeling  that  much  suffering  could  be  pre- 
vented. I  also  recall  a  girl  of  ten,  who  lay  sleep- 
less night  after  night  in  the  greatest  anxiety,  unless 
the  mother  sat  beside  her  and  held  her  hand  until 
she  fell  asleep.  After  one  week's  hypnotic  treatment 
this  habit  was  broken  and  the  child  had  learned  to 
go  to  sleep  alone.  The  importance  of  this  treatment 
chiefly  lay  in  the  fact  that  a  foundation  was  taken 
away  upon  which  otherwise,  in  all  probability,  a 
chronic  insomnia  would  have  grown  up.  I  could 
easily  present  many  such  examples  from  my  own 
experience. 

To  me  the  most  important  of  the  means  we 
have  for  forestalling  neuroses,  seems  to  be  an  early 
training  in  the  exercise  of  a  capacity  for  sublimation. 
A  person,  in  whose  nature  the  different  roads  upon 
which  his  forces  may  find  an  outlet  have  been  broken 
open  ever  since  childhood,  and  who  can  reach  a  cer- 
tain degree  of  freedom  in  tune  with  his  surroundings, 
in  feeling  for  others,  work,  etc., — has  quite  different 
means  at  hand  for  overcoming  destructive  forces, 
than  has  one  who  is  dominated  by  the  compulsion  of 
sexuality.  And  that  it  is  possible  here  to  find  a  de- 
cided line  of  direction  for  the  wavering  pedagogics  of 

our  times,  I  have  a  lively  conviction. 

*          *          * 

After  these  hints  concerning  psychanalysis  in  its 
scientific  and  in  its  therapeutic  form,  I  shall  pass  on 


Science  and  Method  of  Treatment         145 

to  a  part  which  has  to  do  with  the  pressing  question 
of  the  practical  physician;  the  indications  for  such 
treatment,  the  results  hitherto  reached,  eventual  dan- 
gers, etc.  These  questions,  however,  even  less  than 
the  foregoing,  can  be  handled  to  any  great  degree 
of  satisfaction  in  the  present  state  of  affairs. 

Concerning  indications  for  treatment,  it  is  above 
all  to  be  remembered,  that  this,  far  more  than  with 
any  psychic  method,  is  arranged  according  to  the 
individuality  of  the  patient  and  not  according  to  his 
illness.  All  who  have  not,  like  the  insane,  lost  con- 
tact with  the  world,  ought  to  be  approachable  in 
some  degree  by  suggestive  influence.  But  many  less 
can  be  inspired  with  the  clear  and  conscious  outlook 
upon  life,  which  is  the  purpose  of  psychanalysis. 
This  method  puts  considerable  demand  upon  the  in- 
telligence and  character  of  the  patient,  upon  his  will 
to  be  well.  Those  whose  education  is  superficial,  who 
think  themselves  capable  of  understanding  every- 
thing, but  who  have  not  the  ability  of  penetrating  to 
the  bottom  of  anything,  are  eliminated  as  a  matter 
of  course.  The  most  suitable  patient  for  this  method 
of  treatment  is  the  cultured  individual  who  has 
reached  a  dead-lock  half-way  in  the  inner  struggle 
after  clearness  and  truth. 

The  neuroses  which  hitherto  have  accorded  the 
best  results  from  this  treatment,  fall  chiefly  within 
the  rather  diffused  limits  of  hysteria,  and  compul- 
sion and  anxiety  neuroses.  Of  these  results  no  precise 


148      History  and  Practice  of  Psychanalysis 

statistics  can  be  obtained  and  if  one  searches  dili- 
gently it  is  even  difficult  to  place  them  in  the  ordinary 
medical  columns  under  "cured,  improved,  unim- 
proved." Most  of  those  who  come  for  treatment 
have  been  ill  since  childhood,  and  their  nervous  sys- 
tems have  been  powerless  to  bear  the  burden  of  all 
that  has  been  heaped  upon  them  during  the  course 
of  years.  Through  analysis  much  of  this  burden 
falls  away  and  at  the  same  time,  through  an  ex- 
tension of  the  consciousness,  comes  an  added  power 
to  bear.  In  the  best  cases  this  may  mean  health. 
At  least  some  times  I  have  heard  patients  say  that 
after  the  treatment  they  have  grown  healthier  than 
at  any  time  before  it.  But  in  most  cases  it  means 
only  an  aid — and  it  may  have  great  importance  in- 
deed, as  such,  if  it  implies  a  regained  faculty  for 
work,  even  if  the  suffering  remains.  Nevertheless 
we  can  already  assert,  that  illnesses  are  cured  by 
analysis  which  formerly  were  considered  hopeless. 
I  have  myself,  for  example,  published  the  descrip- 
tion of  one  case,  wherein  a  paranoical  system  of  per- 
secution of  ten  years'  standing,  was  entirely  broken 
up,  and  of  which  not  a  trace  of  recurrence  has  ap- 
peared, during  the  six  years  which  have  elapsed  since 
the  conclusion  of  the  treatment.* 

The    hot    opposition    with    which    psychanalysis 
meets,  is  most  often  accounted  for  by  the  idea  that 
it  implies  great  danger.     People  are  of  the  opinion 
*  See  pp.  248-297. 


Science  and  Method  of  Treatment         147 

that  this  prolonged  digging  into  sexual  details  must 
do  harm,  that  changes  for  the  worse  are  seen  very 
frequently  after  treatment  and  that  these  have  di- 
rectly led  to  suicide,  etc. 

How  this  may  be  is  difficult  to  decide.  It  is  in  the 
nature  of  the  treatment  that  it  can  not  always  pro- 
gress as  happily  as,  for  example,  does  the  ordinary 
treatment  by  suggestion.  A  clear  vision  cannot  be 
won  sometimes  without  severe  crises  of  self-examina- 
tion, revealed  in  a  commotion,  which  superficially 
observed  may  be  looked  upon  as  a  change  for  the 
worse.  It  may  easily  happen  that  during  such  times, 
the  ground  sways  under  the  patient,  and  he  blames 
the  doctor  for  robbing  him  of  that  upon  which  he 
had  lived,  without  giving  him  anything  in  its  stead. 
It  may  also  easily  happen  that  the  doctor  over- 
estimates his  ability  for  bringing  about  the  desired 
evolution.  And  it  must  be  remembered  that  some- 
times the  neurosis  itself  is  the  best  of  those  evil 
possibilities,  from  which  the  patient  had  to  choose,  in 
a  determining  situation  in  his  life.  By  depriving  him 
of  this,  conditions  are  not  bettered  in  such  cases. 
The  whole  opens  out  only  a  deeper  understanding 
of  life's  tragedy ;  and  the  value  of  this  may  perhaps 
be  open  to  doubt. 

Naturally  suicide  has  been  committed  during  the 
course  of  psychanalytical  treatment,  just  as  it  has 
during  care  in  sanatoria  or  during  rest-cures.  The 
question  is,  if  the  suicide  can  be  brought  into  psycho- 


148      History  and  Practice  of  Psychanalysis 

logical  connection  with  the  treatment.  I  have  my- 
self, lacked  experience  in  this  field.  Theoretically  it 
should  be  acknowledged  that  this  possibility  is  not 
precluded.  The  neurosis,  as  has  been  said,  sometimes 
may  be  a  kind  of  safety-wall  against  worst  eventuali- 
ties than  itself ;  to  these  eventualities  suicide  belongs. 
It  may  therefore  be  thinkable  that  after  the  de- 
struction of  the  safety-wall,  the  forces  could  compel 
such  a  catastrophe.  I  have  difficulty  however  in 
believing  that  in  reality,  any  such  thing  could  be 
met  with.  If  such  a  danger  were  imminent,  the  pa- 
tient would  instinctively  guard  himself  against  the 
analysis,  so  that  no  analyst  would  be  able  to  go  on 
with  it.  During  the  early  time  of  the  teaching  of 
suggestion  there  was  a  belief  in  the  possibility  of 
suggesting  crime,  among  other  things.  Critical  study 
has  led  to  that  point  now,  where  we  believe  only  in 
the  realization  of  such  suggestions  as  are  in  har- 
mony with  the  innermost  desires  of  the  individual.  It 
is  somewhat  the  same  with  psychanalysis. 

Apropos  of  suggestion,  analysts  are  often  accused 
of  suggesting  to  the  patient  sexual  ideas,  and  things 
pertaining  thereto,  through  faulty  interpretations. 
Analysts  object  that  if  the  interpretation  is  faulty 
the  patient  will  turn  from  it,  without  in  the  slightest 
degree,  being  touched  by  it ;  if  he  reacts  he  shows  in 
this  way  that  the  interpretation  is  true.  There  is 
therefore,  they  explain,  no  danger.  Theoretically 
the  objection  is  valid  enough,  but  I  doubt  if  its  prae- 


Science  and  Method  of  Treatment         149 

tical  application  is  so  free  from  danger  as  it  is  de- 
clared to  be.  It  seems  to  me  that  analysts  often 
without  necessity  awake  the  sleeping  lion ;  especially 
when  they  force  sexual  symbols  out  of  dreams  which 
scarcely  can  have  any  importance  for  the  treat- 
ment. 

Taken  all  in  all  psychanalysis  cannot  be  made  free 
from  the  accusation  that  it  involves  dangers.  With 
added  knowledge,  with  careful  selection  of  suitable 
cases,  with  discretion  and  foresight,  these  dangers 
ought,  however,  to  be  reduced  to  a  minimum.  And 
naturally  with  the  supposition  that  this  method  of 
treatment  shall  be  handled  only  by  physicians  who 
are  fully  masters  of  its  difficulties. 


In  order  to  avoid  misunderstandings  I  must  once 
more  emphasize  the  fact  that  what  I  have  put  down 
must  be  considered  only  as  a  fragmentary  guide 
through  the  most  essential  portions  of  the  teachings 
of  Freud.  Psychanalysis  is  already  so  wide-spread 
a  subject  that  a  text  book  thereon  could  scarcely  be 
limited  to  a  volume  similar  in  size  to  one  concerning 
other  special  branches  of  medicine.  And  in  less  than 
three  years'  special  application  no  one  can  learn 
to  master  the  subject.  I  will  also  repeat  that  I  have 
tried  to  make  the  presentation  of  the  matter  as  ob- 
jective as  possible.  In  spite  of  this,  however,  my  own 


150      History  and  Practice  of  Psychanalysis 

opinion  concerning  it  may  be  apparent  here  and 
there.  That  I  consider  the  teachings  far  more  val- 
uable than  the  shallow  criticisms  which  have  been 
directed  against  them,  I  will  not  deny.  But  their 
value  for  me  lies  more  in  the  great  possibilities,  the 
fruitful  suggestions,  the  bold  overturning  of  new 
ground,  than  in  that  which  already  has  been  pro- 
duced. If  then,  such  rich  promises  are  to  be  ful- 
filled, much  depends  upon  the  coming  of  the  move- 
ment into  the  right  line  of  development  instead  of 
going  astray  upon  the  quick  sands  that  threaten  it. 
One  such  danger  I  must  now  finally  point  out. 

What  disturbs  me  most  in  Freud's  writings  is  an 
occasional  brutal  disregard  of  the  importance  of  the 
conscious  life.  When  Freud,  in  his  study  of  dreams, 
had  extracted  the  latent-content  of  the  dream,  he 
threw  away  the  manifest  dream-picture  and  all  fur- 
ther investigations  had  to  do  with  that  which  was 
brought  to  light  through  analysis.  This  may  be 
done  because  the  manifest  dream-picture  is  in  itself 
an  unimportant  product  of  life.  But  Freud  has  an 
inclination  also  to  throw  aside  the  manifest  content 
of  life,  as  something  of  indifferent  value.  He  is  so 
fascinated  by  all  that  new,  unconscious  world  he 
has  discovered  that  he  is  entirely  lost  in  it.  This 
is,  to  say  the  least,  one-sidedness. 

In  its  last  analysis  all  our  study  has  to  do  with 
the  conscious  life;  the  unconscious  has  interest  only 
in  so  far  as  it  contributes  to  our  knowledge  about  the 


Science  and  Method  of  Treatment         151 

conscious, — not  at  all  in,  and  for,  itself.  One  easily 
gets  the  conception  that  Freud  is  of  the  opinion  that 
illnesses  are  entirely  determined  by  unconscious 
processes.  He  is  himself  quite  satisfied  with  this  one- 
sidedness ;  to  him  it  is  a  means  of  opening  the  eyes  of 
his  contemporaries  to  the  importance  of  the  uncon- 
scious forces.  This  concept  implies  a  certain  self- 
limitation.  But  those  of  his  followers  who  distin- 
guish themselves  more  by  dogmatism  and  enthusiasm 
than  by  self-criticism  and  objectivity,  fall  victims  to 
the  danger  of  driving  this  one-sidedness  to  absurdity. 
This  seems  to  me,  for  example,  to  be  the  case  with 
Ferenczi,  when  he  makes  an  attempt  to  interpret  sug- 
gestion through  an  unconscious  basis  of  explanation 
(the  transference  of  the  father-complex  upon  the 
physician),  and  when  he  does  this  with  the  support  of 
only  three  cases.  For  here  if  anywhere,  the  highest 
conscious  powers  of  life  must  be  taken  into  ac- 
count. 

In  that  degree  to  which  psychanalysis  can  ad- 
vance toward  knowledge  of  the  unconscious  forces, 
without  dimming  the  vision,  because  of  this,  to  the 
importance  of  the  conscious  feelings,  conflicts  and 
thoughts,  it  seems  to  be  to  be  upon  the  right  road 
of  development. 


IV 

THE   ABLER-DOCTRINE    CONCERNING   NEUROSIS 

I  MENTIONED,  in  the  foregoing  chapter,  that 
Alfred  Adler  was  one  of  the  first  to  break  with 
Freud.  It  is  with  his  name  that  the  strong  opposi- 
tion against  Freud  is  connected,  which  during  the 
past  few  years  has  given  psychanalysis  a  general 
tendency  to  divide  into  lines  diverging  in  accord  with 
individual  ideas.  After  a  long  period  during  which 
Adler  strongly  contended  for  a  new  series  of  points 
of  view,  he  separated  himself  entirely  from  Freud  in 
the  year  1911.  He  established  his  own  circle  for 
discussion.  Within  this,  development  has  gone  on  in 
as  directly  opposed  a  line  as  possible,  to  all  that 
which,  during  the  prosperity  of  Freud's  doctrine  con- 
cerning neurosis,  seemed  on  the  road  to  vindication. 
Every  effort  to  bridge  over  the  abyss  which  separates 
the  two  groups  from  each  other,  has  been  unsuc- 
cessful. 

There  can  scarcely  be  anyone,  who  has  come  into 
contact  with  Freud's  writings,  who  has  not  felt  some 
inner  revolt  against  his  doctrines.  I  myself  have 
at  the  same  time  been  both  charmed  by  his  ingenuity 

152 


The  Adler-Doctrine  Concerning  Neurosis       153 

and  distressed  by  the  distorted  pictures  of  life  which 
proceed  out  of  his  sexual-monomania.  But  to  more 
clearly  explain  the  reason  for  this  double  feeling  is  by 
no  means  as  easy  as  one  would  think.  The  followers 
of  Freud  assert  that  all  opposition  against  him  exists 
only  because  of  incapacity  to  endure  the  hard  truths 
he  brings  to  light.  Undoubtedly  there  is  something 
in  this.  But  not  everything.  Even  one  who  will 
not  let  the  dissecting  knife  spare  his  own  heart  for 
the  purpose  of  coming  nearer  to  truth,  may  be  re- 
volted by  Freud.  Perhaps  such  a  one  most  of  all. 
The  reason  lies  deeper  and  must  be  sought  in  the  fact 
that  Freud  unconsciously  must  have  violated  some 
one  of  life's  fundamental  truths.  The  question  is 
which  one? 

The  intention  of  the  foregoing  pages  was  to  give 
as  impartial  a  glance  as  possible  over  the  manner 
in  which  the  Freud  doctrines  were  formulated.  But 
I  could  not  therein  pass  over  Freud's  undervaluation 
of  the  determining  importance  of  the  conscious  life. 
For  him  the  whole  of  our  existence  is  built  up  of 
unconscious  forces  before  which  we  are  driven, 
without,  by  means  of  conscious  consideration,  being 
able  to  regulate  and  direct  their  play.  Over  the 
whole  of  his  teaching  lies  something  of  that  concursu 
atamorum,  which  is  inherent  to  all  materialistic 
points  of  view, — only  with  the  difference  that  here 
there  is  no  meaningless  whirl  of  atoms,  but  a  whirl 


104      History  and  Practice  of  Psychanaly$is 

of  impulses,  thoughts,  actions.  He  speaks  especially 
about  the  dream  carrying  with  it  the  fulfillment  of  a 
wish  and  one  who  superficially  considers  this  idea, 
from  many  points  which  are  similar  in  his  system  of 
teaching,  gets  an  idea  that  he  actually  reckons  with 
some  out-going  effort  of  the  individual  towards  a 
purpose.  But  the  wish  in  the  dream,  according  to 
Freud,  has  always  a  sexual  content, — it  is,  in  other 
words,  not  the  longing  of  the  human  mind  towards 
some  illusive  goal  that  wishes;  it  is  the  body  that 
wishes.  The  fulfillment  of  the  wish  does  not  contain 
the  attainment  of  something  which  one,  as  a  human 
being,  desires;  it  contains  only  the  satisfaction  of 
something  which  one  has  in  common  with  all  the 
rest  of  organic  nature, — an  expansion  of  forces  that 
have  their  origin  elsewhere  than  in  the  human  mind. 
A  patient  who  already  had  undergone  three  Freud 
analyses  said  to  me: — "Nothing  exasperated  me  so 
as  this  constant  talk  of  sexual  desires.  That  my 
dreams  often  did  concern  themselves  with  erotic 
things,  I  freely  admit.  But  there  was  not  one  trace 
of  desire  in  it.  The  whole  of  my  life  on  the  con- 
trary, was  directed  towards  a  single  wish,  to  become 
free  from  that  which  forced  itself  upon  me  like  some 
strange  hostile  power."  Always  when  Freud  talks 
about  the  wish,  it  really  means  something  which  has 
nothing  to  do  with  the  human  strife  toward  an 
intentional  purpose.  It  will  be  a  difficult  matter 


The  Adler-Doctrme  Concerning  Neurosis       155 

to  find  anything  in  all  that  he  has  written  which 
contains  finality  in  its  essential  meaning. 

This  general  feature  has  greater  possibilities  than, 
at  first  glance,  might  be  believed.  It  cannot  be  un- 
derstood unless  it  is  seen  in  connection  with  science 
as  a  whole.  In  an  earlier  stadium  we  had  a  belief 
that  science  could  give  an  answer  to  the  great  prob- 
lem of  life, — that  it  would  be  able  to  unveil  the 
mystery  as  to  whence  we  came,  and  make  plain  the 
nature  of  our  being;  that  it  would  be  able  to  find 
some  common  intention  in  existence,  a  goal  towards 
which  all  forms  of  life  strove.  Since  science  took  on 
its  modern  form  we  have,  however,  left  all  such  ideas 
behind.  All  questions  about  aims,  purposes,  etc., 
have  been  banished  from  scientific  research  and  it  has 
been  limited  to  the  application  of  causal-laws  to  ob- 
servable phenomena;  science  has  only  to  do  with 
facts  and  the  verification  of  the  causal  relations  in 
which  these  facts  stand  to  one  another.  It  was  un- 
doubtedly due  to  the  consistent  pursuit  of  this  line 
of  development,  that  modern  science  reached  its  great 
upward  swing.  It  has  thus  been  shown,  that  nothing 
was  so  stupefying  and  misleading  for  original  re- 
search in  natural  science,  as  the  blending  into  its 
work  of  questions  concerning  aims,  purposes,  etc.  It 
is  often  hard  to  avoid  stopping  at  such  questions 
when  they  force  themselves  upon  us ;  but  in  so  doing 
research  is  soon  broken  up  into  a  subjective  philos- 
ophising which  leads  away  from  the  objective  clear- 


156      History  and  Practice  of  Psychanalysis 

ing  up  of  the  world  of  phenomena  after  which  we 
strive. 

Freud  is  an  unusually  true  child  of  his  time,  who 
is  quite  ruled  by  the  modern  principles  of  research 
in  natural  science.  As  I  already  have  said,  he  began 
his  work  in  the  school  of  Charcot;  and  this  he  did 
not  do  for  nothing.  Charcot's  greatest  service  lies 
in  the  fact  that  he,  more  than  any  other,  contributed 
to  draw  the  hitherto  wavering  sphere  of  the  neurolo- 
gist within  the  boundaries  of  exact  research.  When 
Freud's  interest  was  turned  in  the  direction  of  psy- 
chology, it  was  his  effort  in  the  same  way  to  draw 
this  into  the  main  channel  of  scientific  unfoldment. 
This  meant  an  unchanged  application  of  the  same 
fundamental  principles.  On  the  one  hand  he  endeav- 
ored to  separate  psychology  from  biology,  study  of 
the  brain,  psycho-physics,  metaphysics,  philosophy 
and  other  fields,  with  which  it  hitherto  had  been  en- 
cumbered, in  order,  in  this  way,  to  constitute  it  as  an 
independent  science;  on  the  other  hand  he  tried  to 
eliminate  from  this  new  science  every  point  of  view 
other  than  the  purely  causal,  in  order  that  it  might 
thus  be  installed  in  the  ranks  of  science  as  a  totality. 
Every  inner  phenomenon  became  for  Freud  only  the 
result  of  pre-existant  forces  and  could  be  disposed  of 
in  the  same  way  a  physical  phenomenon  is  disposed 
of,  (as  for  example  an  eclipse  of  the  sun),  in  decided 
force-qualifications.  And  as  little  as  nature  in  an 


The  Adler-Doctrine  Concerning  Neurosis       157 

eclipse  of  the  sun  is  struggling  after  anything,  or 
has  any  aim  in  view  with  this  phenomenon,  just  as 
little  was  there  any  momentum  of  strife  after  a  pur- 
pose in  anything  that  happens  in  the  human  soul. 
The  secret  of  Freud's  sexual  doctrine  is  only  that  he 
would  arrange  every  phenomenon  of  the  soul-life 
according  to  that  power  which  most  strongly  rules 
organic  nature.  At  the  same  time  the  way  in  which 
the  mentality  works  is  also  stamped  with  the  mean- 
ingless unintentional  character,  which  is  inextricably 
bound  up  in  the  idea.  The  psychic-life  of  humanity 
is  deprived  of  all  the  special  functions  which  we  are 
accustomed  to  connect  with  the  meaning  of  humanity. 
It  seems  to  me  to  be  this,  which  above  everything  else 
makes  one  instinctively  rebel  against  the  psychology 
of  Freud.  And  rebel  with  right,  for  human  life  does 
not  allow  itself  to  be  once  for  all  solved  solely  from 
causal  postulations. 

Against  this  one-sidedness  of  Freud's,  sooner  or 
later  there  must  have  come  a  revolt. 

This  revolt  is  embodied  in  Alfred  Adler. 

I  shall  now  try  to  make  plain  his  starting  point 
and  show  how  from  this  point  he  arrived  at  a  general 
psychology  and  characterology,  on  the  foundation 
of  which  he  believed  he  would  be  able  to  solve  the 
difficult  problem  of  the  doctrine  concerning  neuroses. 
I  shall  afterwards  point  out  how,  from  his  stand- 
point, he  tried  to  put  a  different  value  on  those  facts, 


158      History  and  Practice  of  Psyclianalysis 

which  psychanalytical  research  brought  to  light  and 
in  which  Freud  sees  examples  of  the  all-pervading 
force  of  sexuality. 


In  separating  from  Freud,  Adler  had  a  purely 
biological  starting  point.  While  Freud  began  his 
activity  by  translating  into  his  own  tongue  the  works 
of  the  French  hypnotists  and  practicing  his  profes- 
sion in  accordance  with  their  methods,  Adler's  most 
important  first  work  was  his  article  "Studien  iiber 
Minderwertigkeit  von  Organen."  In  this  he  consid- 
ered all  the  usual  imperfections  in  the  organism  of 
the  child  and  tried  to  interpret  their  origin  from 
the  biological  point  of  view.  It  is  not  my  purpose  to 
take  up  this  important  matter  more  closely ;  in  this 
connection,  it  is  only  of  interest  to  see  how  from  such 
a  starting  point,  he  came  to  the  study  of  neuroses. 
The  way  for  it  was  staked  out  already  in  the  article 
mentioned  and  Adler's  subsequent  work  has  consisted 
in  further  elaboration  of  this. 

How  nature  tries  to  make  redress  if  an  organ  sus- 
tains an  injury,  by  some  process  of  organic  develop- 
ment which  compensates  for  the  disturbance  originat- 
ing through  the  injury,  is  a  well  understood  phe- 
nomenon. If,  for  example,  some  of  the  valves  of 
the  heart  are  destroyed,  the  heart  must  then  perform 
additional  work;  as  a  consequence  the  muscular  ac- 


The  Adler-Doctrine  Concerning  Neurosis       159 

tivity  increases,  so  that  it  can  fully  carry  out  the 
new  demands  upon  it.  Or  if  one  kidney  is  removed, 
the  remaining  one  enlarges,  so  that  it  can  do  the 
work  of  both.  Adler  points  out  another  kind  of  com- 
pensatory arrangement  of  nature  and  an  understand- 
ing of  this  is,  according  to  his  meaning,  very  im- 
portant, because  only  by  means  of  it  as  a  starting 
point  is  it  possible  to  comprehend  the  building  up  of 
neuroses. 

An  organ's  capacity  for  work  depends  not  only 
upon  its  physical  condition  but  even  more  decidedly 
upon  the  nerve  impulses  which  go  out  to  it  from  the 
central  nervous  system.  Everybody  knows  how  by 
means  of  a  vigorous  tension  of  will  it  is  possible  to 
accomplish  work  which  under  ordinary  conditions 
one  is  powerless  to  perform.  Accordingly  a  physic- 
ally defective  organ  can  be  made  to  function  nor- 
mally by  means  of  augmented  nerve  impulses.  The 
physical  deficiency  is  compensated,  in  other  words, 
by  an  energetic  over-efficiency.  But  this  arrange- 
ment of  nature  easily  carries  with  it  an  over-sensi- 
tiveness in  the  weakened  organ,  and  it  is  this  which 
lays  the  foundation  for  nervous  suffering.  In  exam- 
ining, for  instance,  an  adult  who  is  subject  to  nervous 
diarrhoea,  it  is  almost  invariably  found  that  before 
this  particular  disturbance  began,  he  had  had  some 
physical  trouble  in  the  intestinal  tract.  This  may 
lie  far  back  in  his  past,  e.  g., — it  may  have  lasted 
for  some  months  during  the  first  years  of  life.  Even 


160      History  and  Practice  of  Psychanalysw 

if  it  had  apparently  been  cured,  it  may  have  left  be- 
hind it  a  weakness,  or  an  oversensitiveness,  which  a 
few  decades  later  may  appear  in  some  form  of  neu- 
rosis. What  is  thus  true  concerning  an  organ  or 
organic  system,  is  also  true  when  it  concerns  the 
organism  as  a  whole.  If  the  subject  of  the  childhood 
is  brought  up  when  a  neurotic  is  examined,  the  fol- 
lowing will  often  be  heard: — "I  was  weak  and  tired 
even  at  that  time,  was  quite  done  up  with  my  school 
work,  was  tormented  by  a  disability  that  put  me  be- 
hind," etc.  In  the  same  way  in  which  a  single  weak- 
ened organic  function  may  be  sustained  on  account  of 
dynamic  compensation,  so  is  it  also  with  the  whole 
of  a  poorly  equipped  organism.  This  explains  too, 
an  apparently  paradoxical  circumstance,  how  one 
often  finds  great  feats  of  strength  emanating  from 
individuals  of  relatively  weak  physical  development. 
They  are  obliged  to  keep  their  will-tension  in  con- 
stant training,  in  order  to  keep  up  at  all;  and  be- 
cause of  this  unnaturally  disciplined  power  they  are 
able  sporadically  to  accomplish  amazing  things.  To 
this  class  belongs  that  spasmodic  manner  of  working 
so  characteristic  of  the  nervous  sufferer;  after  a 
sporadic  flaming  up  of  the  forces,  this  class  of  pa- 
tients may  at  once  sink  back  into  a  state  of  exhaus- 
tion. They  are  well  known  for  their  good  begin- 
nings, good  ideas, — but  they  are  unable  to  carry 
anything  through  to  the  end.  The  over-sensitiveness 
of  neurotics  belongs  to  the  same  category.  Every 


The  Adler-Doctrine  Concerning  Neurosis       161 

part  of  the  organism  responds  with  exaggerated  vi- 
brations to  whatever  takes  place  about  this  class  of 
patients.  Of  course  the  results  of  these  arrange- 
ments of  nature  may  be,  in  different  cases,  extremely 
changeable,  dependable  partly  upon  the  high  degree 
of  original  impairment,  partly  upon  the  degree  to 
which  compensation  has  succeeded.  Adler  places  be- 
side one  another  the  three  conceptions :  degeneration 
— neurosis — genius.  In  the  first  case  the  compensa- 
tion has  been  unsuccessful,  just  as  much  as  it  has 
fully  succeeded  in  the  last.  The  degenerate  sinks  out 
of  life  in  the  same  way  that  genius  lifts  itself  up  to 
capability  for  fitting  itself  to  a  new  type  of  life.  The 
neurotic,  in  more  or  less  heterogeneous  blending, 
shows  features  of  both, — he  wavers  between  the  two 
extremes,  unable  to  find  a  permanent  resting-place. 

From  the  biological  starting  point,  Adler  came 
over  to  the  psychology  of  neurosis-formation,  by 
going  more  deeply  into  the  question  as  to  how  or- 
ganic deficiency  acts  upon  the  sufferer's  mental  life 
and  character-development.  He  in  this  way,  discov- 
ered many  interesting  things. 

The  most  apparent  consequence  of  an  organic 
weakness  is  that  it  attracts  attention  to  itself  and 
demands  a  certain  interest.  If  one  has  a  weak  heart, 
one  must  think  about  it  and  be  on  guard  continually 
to  take  proper  care  of  it ;  it  cannot  be  left  to  itself 
as  if  it  were  in  a  state  of  health.  Because  of  this 
directing  of  the  attention  upon  an  over-sensitive  or- 


162      History  and  Practice  of  Psych  analysis 

gan  its  sensitiveness  is  drawn  farther  along  the  path 
of  auto-suggestion.  I  have  already  in  another  con- 
nection pointed  out  the  importance  of  the  attention 
for  the  formation  of  suggestions.  Here  the  way  lies 
open  for  hypochondriacal  puttering  with  the  body 
and  its  pains.  Disturbances  of  this  nature  may  be 
quite  amenable  to  suggestive  treatment. 

But  far  more  serious  than  the  exaggerated  cher- 
ishing of  the  weak  organ  and  of  the  enfeebled  organ- 
ism are  the  more  special  psychic  reactions  which 
the  enfeeblement  forces  to  the  surface.  It  not  only 
strives  to  imprison  the  sufferer's  faculty  of  interest, 
— it  tries  also  to  put  its  stamp  upon  his  emotional 
life,  to  annihilate  its  free  activity  and  to  drive  it 
into  a  road  of  compulsion,  which  is  fatal  to  any  fur- 
ther development.  The  organic  defect  produces  a 
feeling  of  deficiency,  a  feeling  that  the  sufferer  is 
worth  less  than  his  fellows;  and  this  fundamental 
impression  of  the  feelings  in  its  turn,  forces  out  dis- 
placements in  development  along  different  lines,  the 
result  being  nervous  types  of  character  and  disease. 

It  may  be  easier  to  make  all  this  plain  by  means 
of  a  simple  example. 

Suppose  a  strong,  energetic,  happy  boy  becomes 
suddenly  ruptured.  He  is  taken  to  a  physician,  is 
examined  and  given  careful  orders; — he  must  keep 
out  of  the  gymnasium,  must  give  up  athletics,  must 
not  run,  must  not  fight ;  he  must  pay  such  attention 
to  himself  that  never  will  he  thoughtlessly  forget  to 
follow  the  doctor's  directions.  For  if  he  should  for* 


The  Adler-Docttine  Concerning  Neurotit       168 

get,  something  dangerous  might  happen, — he  might 
have  to  be  operated  upon  at  once  in  order  to  save  his 
life,  etc.  The  boy  is  thus  compelled  to  divide  his 
attention  between  the  rupture  and  everything  which 
hitherto  has  been  a  source  of  pleasure  to  him.  He 
no  longer  can  devote  himself  to  anything  with  the 
same  undisturbed  interest  as  before;  the  fact  of  the 
illness  forces  itself  continually  upon  him.  He  has 
always  to  be  on  his  guard.  In  this  last  circum- 
stance perhaps,  lies  by  far  the  more  significant  mo- 
ment. For  it  means  that  the  hitherto  spontaneous, 
self-evident  connection  with  the  surrounding  world 
has  been  broken.  A  human  being  lives  only  through 
reciprocal  action  between  himself  and  the  external 
world;  if  life  goes  on  harmoniously  this  reciprocal 
action  is  so  self-evident  that  it  is  never  even  a  sub- 
ject for  reflection.  This  is  the  state  of  the  child 
who  still  keeps  a  dim  memory  of  its  condition  in  the 
mother's  body,  where  it  was  completely  at  one  with 
its  surroundings.  The  boy  who  formerly  had  gone 
his  way  without  extra  consideration  as  an  established 
part  of  the  family,  in  the  circle  of  his  comrades, 
in  school,  now  feels  that  danger  threatens  him  every- 
where. Instead  of  being  taken  up  and  cherished  as 
heretofore  by  the  world  about  him,  it  has  now  be- 
come an  enemy  which  meets  him  at  every  turn.  "You 
must  not  go  with  the  others  to  the  gymnasium."  He 
is  weaker  than  the  others,  incapable  of  doing  the 
same  things  they  do;  he  is  put  aside, — alone.  The 
restraint  he  must  constantly  lay  upon  himself 


164      History  and  Practice  of  Psychanalysis 

awakens  in  him  as  constantly,  a  feeling  of  being  out 
of  sorts.  Those  things  which  formerly  delighted 
him  no  longer  please  him.  Everything  that  had 
amused  him  he  now  must  guard  himself  against; 
pleasure  itself  becomes  an  enemy.  He  feels  himself 
obliged  to  find  some  means  of  getting  out  of  this 
condition ;  and  as  this  thought  forces  itself  upon  him, 
life  becomes  a  problem, — a  problem  that  the  more 
perplexes  him,  becomes  the  more  insolvable,  the  more 
he  broods  over  it. 

All  this  has  to  do  with  a  case  in  which  the  child 
comes  upon  a  defect  during  its  development,  which 
places  it  in  a  difficult  situation.  Almost  the  same 
thing  takes  place  when  a  person  enfeebled  from  the 
very  start,  becomes  conscious  of  his  inferiority. 

As  a  rule  we  take  for  granted  that  the  life  of  a 
child  is  very  simple.  If  an  adult  could  recall  every- 
thing experienced  during  the  first  ten  years  of  life, 
other  conclusions  would  be  reached.  All  the  strug- 
gle after  favor,  the  effort  to  keep  up  on  a  level  with 
others,  to  overreach  competition, — all  these  things 
which  rule  the  greater  part  of  the  life  of  the  adult, 
are  by  no  means  unknown  to  the  child.  Rather  the 
contrary.  The  child  who  cannot  stand  on  his  own 
legs  is  absolutely  dependent  upon  surroundings ;  their 
verdict  becomes  of  radical  importance.  If  the  child 
loses  the  good  graces  of  those  nearest  it,  goes  under 
in  the  competition  with  brothers,  sisters  or  comrades, 
it  is  a  far  more  miserable  experience  than  a  grown 


The  Adler-Doctrine  Concerning  Neurosis       165 

person  as  a  rule,  can  imagine.  What  despair  and 
oppression  then  it  must  be,  to  be  from  the  very  be- 
ginning oppressed  by  a  feeling  of  inferiority.  Con- 
sider a  little  girl  when  she  discovers  that  she  does  not 
possess  the  beauty  or  lovableness,  by  means  of  which 
she  naturally  would  win  all  hearts.  This  is  so  much 
the  worse  when  the  feeling  of  aloofness,  which  such 
an  experience  carries  with  it  cannot  be  cleared  away ; 
— how  can  a  child  explain  to  a  grown  person  what 
it  suffers  under  such  circumstances, — it  does  not  even 
understand  itself  what  is  going  on  within  it. 

There  arises  now  a  serious  question  as  to  what  a 
child  may  do  when  it  has  thus  come  askew  with  life 
and  when  this  state  becomes  an  insolvable  problem. 

The  answer  is  simple: — the  child  exchanges  the 
real  world  it  has  lost,  for  a  world  of  illusion. 

The  old  legend  of  Paradise  is  capable  of  many 
interpretations  of  which  one  and  all  may  contain  a 
seed  of  truth.  But  I  wonder  whether  just  that  sec- 
ond in  which  this  change  takes  place,  does  not  con- 
struct the  most  material  boundary  between  the  orig- 
inal relative  state  of  harmony  and  its  breaking  up 
into  turbulent  dissension.  Paradise — that  is  the 
world  into  which,  without  reflection  we  flow  together 
with  the  whole,  in  which  each  one  is  a  part  and  of 
which  each  life  is  a  symbol.  Happiness — that  is  the 
feeling  when  our  forces  radiate  without  obstruction, 
touching  into  life  all  with  which  they  come  in  con- 
tact, as  we  are  borne  on  by  the  creating  power 


166      History  and  Practice  of  Psychanalytis 

Into  the  world  of  the  damned  comes  he  who  no  longer 
is  a  partaker  in  all  this  joy,  who  withers  within  him- 
self,— longing  only  after  fantasies  that  fade  into 
nothingness  as  he  tries  to  grasp  them. 

We  may  be  pretty  sure  that  the  child  to  whom  the 
real  world  becomes  an  affliction,  will  try  to  find  its 
way  out  of  its  trouble  by  living  more  and  more  deeply 
in  the  world  of  fantasy.  All  those  desires  which 
could  not  find  realization  in  actuality,  become  ful- 
filled in  imagination.  If  a  boy  gets  the  worst  of  it  in 
a  fight  with  some  comrade,  he  unfailingly  constructs 
afterwards,  a  fantasy  in  which  he  is  the  rightful 
victor.  The  more  evident  the  whipping  was,  just 
the  more  unrestrained  works  his  imagination,  in  or- 
der that  his  humiliation  may  thus  be  counteracted. 
The  notoriously  weak  and  feeble,  in  their  dreams, 
become  great  soldiers  who  crush  hordes  of  enemies 
and  let  the  sun  of  their  own  power  shine  upon  poor 
human  slaves.  The  little  girl,  ugly  even  to  disfigure- 
ment, becomes  a  great  enchantress,  whom  no  one  can 
resist. 

Most  of  those  who  have  had  to  do  with  children 
have  undoubtedly  noticed  sometime  how  a  formerly 
sound  and  happy  child  changes  and  grows  shy  and 
reserved,  reticent  and  irritable.  The  inner  change 
makes  its  appearance  externally  in  this  way.  The 
child  wants  to  be  left  in  peace  with  its  fantasies,  re- 
acting with  irritability  against  everything  which 
would  detach  it  from  them.  It  cannot  speak  about 


The  Adler-Doctrvne  Concerning  Neurosis        167 

the  things  which  fill  its  thoughts, — therefore  it  does 
not,  as  a  rule,  speak  at  all.  The  fatality  in  this 
displacement  lies  simply  in  the  fact  that  it  is  so 
difficult  to  right,  when  it  takes  place  in  this  early 
stadium.  Grown  people  too,  may  occasionally  fill 
up  the  gap  left  by  some  disappointment,  by  means 
of  imagination, — in  this  manner  retrieving  the  loss. 
But  if  one  has  been  firmly  set  on  the  path  of  reality 
it  is  not  hard  to  return  to  it  again.  Entirely  dif- 
ferent however,  is  the  case  of  a  child  who  has  not  yet 
fitted  itself  into  that  reality,  in  which  it  is  to  live,  nor 
acquired  a  connection  with  it.  If  imagination  takes 
possession  of  it,  this  may  all  too  easily  become  the 
world  in  which  it  truly  lives.  It  is  by  no  means 
unusual  that  a  child  is  not  even  able  to  separate 
fantasy  from  reality,  but  with  entire  sincerity  be- 
lieves in  its  imaginings  rather  than  in  its  real  experi- 
ences. 

All  this  however,  carries  along  with  it  under  dif- 
ferent circumstances,  widely  different  consequences. 
The  matter  is  best  understood  if  Adler*s  grouping  of 
terms  is  kept  in  mind: — degeneration — neurosis — 
genius.  The  difference  in  these  three  instances 
depends  upon  the  degree  to  which  the  enfeebled 
individual  has  been  able  to  conpensate  for  his  en- 
feeblement.  It  thus  finally  means  the  inner  power 
of  production.  But  because  the  whole  of  that  proc- 
ess through  which  a  compensation  is  produced,  has 
so  much  to  do  with  fantasy,  it  is  scarcely  possible  to 


168      History  and  Practice  of  Psychanalysis 

get  a  true  conception  of  it  without  having  in  mind 
the  excessively  great  part  which  fantasy  plays  for 
any  one  who  is  burdened  with  the  feeling  of  inferior- 

ity- 

What  is  most  characteristic  about  the  mental  life 
of  the  degenerate,  is  that  mass  of  shadowy  fantasies 
upon  which  he  lets  himself  weakly  be  carried  away. 
The  baron  .in  Gorki's  "Night  Refuge"  is  a  charac- 
teristic type;  he  has  slipped  down,  from  the  aristo- 
cratic position  in  which  he  was  born,  into  the  most 
wretched  dregs  of  society,  without  knowing  how  he 
got  there.  The  whole  of  the  external  world  has  had 
for  him  so  little  reality-value,  that  passage  through 
it  was  not  even  registered  as  a  mechanical  memory; 
— only  empty  fantasies  altogether,  fantasies  that 
broke  before  his  eyes  like  soap-bubbles,  without  his 
lifting  a  hand  to  try  to  grasp  them.  At  the  same 
time  that  this  moving  along  on  the  formless  stream  of 
imagination  disintegrates  the  inner  life  into  unreal- 
ity, it  carries  the  individual  farther  and  farther 
away  from  the  outside  reality.  This  is  fatal  simply 
because  the  degenerate^  through  it,  is  deprived  of 
all  necessity  for  that  adaptation,  which  the  outside 
world  always  means  to  the  sound  mind.  Everyone 
may  chance  to  go  astray;  but  when  one  least  sus- 
pects it  one  feels  the  iron  grip  of  necessity.  And 
this  carries  one  back  where  one  must  go.  But  for 
the  degenerate,  that  must  of  outside  necessity,  re- 
mains an  unreality  like  all  the  rest. 


The  Adler-Doctrine  Concerning  Neurosis       169 

Things  take  on  another  aspect  when  an  abyss 
yawns  beneath  a  strong,  talented  child  and  that 
world  in  which  it  has  lived  hitherto  as  a  homoge- 
neous part.  It  also  may  be  pushed  back  by  its  sur- 
rounding circumstances  and  overwhelmed  by  their 
verdict: — "You  are  lazy,"  we  say, — "You  have  a 
poor  memory.  You  can  never  learn  to  parse  verbs 
as  well  as  others;" — even  such  little  things  may  be 
pressed  down  into  the  feeling  of  inferiority.  But 
when  a  child  must  admit  its  disadvantage  it  always 
does  so  with  certain  reservations : — "In  other  ways," 
it  says  to  itself,  "I  am  superior.  Just  wait  and  Fll 
show  you  what  I  can  do !"  The  most  gifted  likewise 
may  be  forced  out  of  the  world  of  reality  into  that  of 
fantasy.  But  for  them  from  the  very  beginning,  fan- 
tasies have  had  a  stamp  of  higher  reality.  Out  of 
such  fantasies  presently  proceed  a  form  of  life  that 
in  its  deepest  significance  comes  nearer  to  the  real 
than  that  from  which  it  has  been  separated ; — it  may 
mean  the  inventor's  improvement  of  material  condi- 
tions, the  politician's  solution  of  municipal  problems, 
or  the  poet's  revelation  of  a  world  of  inner  beauty.  In 
a  word,  the  instant  a  creative  genius  is  thrown  out  of 
banal  reality,  forces  within  are  set  in  motion  which 
sometime  may  become  the  source  of  new  life  and 
due  to  which  a  nobler  human  type  may  be  created. 
If  a  person,  as  a  rule,  is  to  become  anything  else 
than  one  ingredient  in  the  mass,  stamped  by  its  af- 
fects and  with  all  its  lack  of  spirituality,  he  must 


170      History  and  Practice  of  Psyclianalysis 

at  a  very  early  stage  have  been  left  alone  to  face  the 
difficulties  of  life.  No  work  bears  the  imprint  of 
genius,  unless  already  in  childhood  the  worker  learned 
to  take  hold  of  existence  in  an  original  way  and  to 
solve  its  conflicts  by  means  of  his  original  qualifica- 
tions. The  whole  of  this  process  of  individualizing 
and  independent  productivity  which,  in  the  adult, 
breaks  forth  in  a  life  of  action  and  at  the  same  time 
frees  himself  and  draws  others  towards  a  higher 
form  of  life,  all  this  process  must  have  had  its 
foundation  laid  almost  simultaneously  with  the  dawn 
of  consciousness  and  must  then  have  developed  dur- 
ing the  whole  period  of  growth;  only  then  is  it 
genuine. 

The  neurotic,  as  I  have  said  already,  occupies  a 
place  between  the  two  extremes.  He  keeps  himself 
within  the  framework  of  the  outside  reality ;  but  he 
lives  either  upon  fantasies  which  have  nothing  to  do 
with  reality, — or  else  makes  continual  unsuccessful 
efforts  to  overcome  it  as  a  creator.  To  Adler, 
Strindberg  is  the  embodiment  of  this  conception.  It 
is  well  known  how,  in  childhood,  Strindberg  suffered 
from  an  over- ruling  feeling  of  inferiority ;  and  all  his 
after  life  was  a  series  of  desperate  efforts  to  work 
himself,  in  the  most  widely  separated  ways,  up  out 
of  this.  All  that  he  aimed  to  construct  to  this  end, 
soon  collapsed  and  he  again  stood  in  the  same  place 
as  before.  In  spite  of  all  his  unprecedented  power  for 
creating,  he  never  succeeded  in  bringing  out  one  sin- 


The  Adler-Doctrine  Concerning  Neurosis       171 

gle  value  that  became  established  for  himself  or 
could  show  a  way  on  for  others ; — it  all  dissolved  in 
chaos.  Finally  he  succumbed  to  the  feeling  of  in- 
feriority, with  which  he  had  started  out,  dying  with 
the  cross  before  his  eyes  and  hate  in  his  heart; — 
the  cross,  which  is  the  everlasting  symbol  of  inability 
to  master  the  earthly  life,  and  hate,  which  is  only  the 
negation  of  all  emotional  value. 

From  this  general  standpoint  let  us  go  on  to  a 
more  critical  examination  of  the  formation  of  neu- 
roses in  detail,  according  to  Adler's  opinions.  Ad- 
ler's  strength  lies  in  his  limitations  and  in  his  logi- 
calness.  The  whole  of  his  work  consists  of  a  study 
of  those  different  ways,  by  which  compensation-for- 
mations seek  a  way  out.  All  this  may  be  gathered 
together  in  two  broad  strokes ; — one  Adler  called 
"die  Sicherung,"  the  other  he  called  "der  mannliche 
Protest." 

Freud  had  already  pointed  out  that  neurosis  is  a 
flight  away  from  life  into  the  realm  of  disease.  Ad- 
ler has  laid  stress  upon  the  way  in  which  life,  for 
him  who  is  burdened  with  a  feeling  of  inferiority, 
comes  to  be  looked  upon  as  one  big  danger.  It  is 
not  enough  to  flee  continually  from  this  danger,  one 
must  always  try  as  well,  to  guard  one's  self  against 
it.  As  little  as  the  weak  can  go  to  meet  trouble  with 
an  open  mind,  in  order  through  these  troubles,  as 
through  hell-fire,  to  arrive  at  abiding  harmony,  just 
as  little  is  such  a  one  able  to  make  himself  secure  be- 


172      History  and  Practice  of  Psychanalysis 

forehand,  by  building  life  up  upon  a  genuine  founda- 
tion of  truth  and  undisturbed  reality.  He  tries 
instead  to  defend  himself  by  means  of  various  strata- 
gems. Adler  has  a  great  faculty  for  catching,  be- 
hind all  neurotic  symptoms,  a  glimpse  of  diverse  delu- 
sions, illusions,  poses,  attitudes ;  tersely,  unrealities 
behind  which  the  neurotic  tries  to  defend  himself 
from  the  unmercifulness  of  reality.  He  solves  a 
great  part  of  the  symptomatology  by  this  rearing 
up  of  sham  barricades. 

There  is  no  doubt  that  the  defense-mechanism 
plays  a  main  part  in  a  great  number  of  neurotic  con- 
ditions. The  man  who  struggles  with  his  polygamous 
tendencies  and  wishes  to  escape  prostitution,  rears 
up  in  his  mind  the  syphilis-phobia  syndrome,  and  be- 
hind this  wall  feels  himself  safe;  because  he  is  over- 
come with  anxiety  and  thinks  only  of  this  deadly 
peril  into  which  he  might  fall  merely  through  one 
kiss,  he  never  needs  to  fear  that  he  will  become  the 
victim  of  venality.  The  wife  who  wishes  to  escape 
the  marriage  connection  and  the  bearing  of  many 
children,  notices  some  vague,  uncomfortable  feelings 
in  her  reproductive  organs ;  she  grasps  these  feelings 
as  a  drowning  man  grasps  a  straw,  she  makes  as 
much  as  she  can  of  them  until  they  become  an  actual 
pain  which  necessitates  long-standing  local-treatment 
from  a  clever  specialist, — it  may  even  happen  that 
she  has  her  home  in  a  country  town,  but  that  the 
specialist  can  be  seen  only  in  a  metropolis  where  she 


The  Adler-Doctrine  Concenwng  Neurosis       173 

has  always  longed  to  live.  The  young  girl,  who  has 
been  put  into  an  office  and  finds  the  montony  of  the 
work  there  as  loathsome  as  she  finds  the  boldness  of 
the  men,  suddenly  gets  agoraphobia, — there  is  noth- 
ing to  do  but  to  allow  her  to  stay  at  home  and 
escape  her  part  towards  helping  in  the  home's  com- 
mon support.  The  teacher  who  has  too  much  to  do, 
faints  in  the  middle  of  a  lecture, — she  is  carried  home, 
gets  a  free  day  and  thus  defends  herself  against  over- 
tiredness.  The  further  advanced  neurotic  who  al- 
ready spends  life  in  bed  and  thinks  it  monotonous 
to  be  alone,  gets  peculiar  attacks  in  which,  for 
example,  he  rushes  to  the  window  and  tries  to  throw 
himself  out;  these  attacks  necessitate  the  continual 
presence  of  a  nurse,  in  spite  of  the  fact  that  the 
family  can  little  afford  the  luxury.  A  poor  woman 
who  suffers  from  her  insignificant  position  in  life, 
when  she  moves  to  any  new  place,  may  attempt 
suicide,  so  that  everyone  is  frightened  and  she  is 
thus  made  a  topic  of  general  conversation,  as  if  she 
were  some  great  celebrity; — so  for  a  time  she  is  as- 
sured against  the  pangs  of  obscurity.  Examples 
innumerable  might  be  given. 

It  is  evident  that  an  understanding  of  this  de- 
fense-mechanism is  of  especial  importance  for  every 
practising  physician.  For  it  is  very  often  with  the 
assistance  of  the  doctor  that  neurotics  are  successful 
in  carrying  through  this  stratagem.  The  patient 
himself  has  no  comprehension  of  the  trouble  to  which 


174>      History  and  Practice  of  Psychanalysis 

he  has  suddenly  fallen  a  victim.  In  spite  of  the 
fact  that  in  its  very  nature  it  is  something  illusory, 
he  accepts  it  as  reality,  and  in  this  fact  the  neurosis 
lies.  The  family  is  unable  to  explain  the  right  con- 
nection, although  they  often  have  a  faint  suspicion 
of  it.  If  then  the  physician  comes  and  with  his 
authority  supports  the  tendency  to  ill  health,  the 
patient  succeeds  in  putting  it  through  in  spite  of 
all  opposition.  Far  from  being  nullified  by  prescrip- 
tions which  have  no  causal  connection  with  the  for- 
mation process  of  the  illness,  these  act  only  as  a 
means  of  working  it  more  firmly  into  the  nervous 
system.  The  harm  which  has  in  this  way  been  done 
in  the  handling  of  neuroses  through  routine  treat- 
ment, isolating  cures,  and  other  blunders,  can  scarce- 
ly be  estimated.  There  is  no  possibility  of  coming  to 
a  rational  way  of  treating  neuroses  without  a  gen- 
eral collegial  understanding  of  this  thing.  We  must 
not  forget  that  the  over-coming  of  a  defense  mech- 
anism demands  work  from  within,  and  may  often  be 
painful  and  take  the  energy  of  years.  When  the 
patient  finds  out  that  he  no  longer  is  left  in  peace 
but  must  take  up  the  battle  of  life  in  order  to  be 
well, — then  he  runs  to  some  other  doctor.  And  this 
one  perhaps  lets  him  once  more  sink  back  into  his 
protective  measures,  and  by  so  doing  cuts  off  the 
road  to  health  which  had  begun  to  be  cleared  out. 

It  may  indeed  be  a  difficult  task  to  once  more 
take  hold  of  life  when  a  man  has  well  established 


The  Adler-Doctrine  Concerning  Neurosis       175 

himself  as  a  neurotic,  under  this  defense-mechanism. 
But  on  the  other  hand  it  not  infrequently  happens 
that  severe  symptoms  which  have  been  built  up  in  this 
manner,  disappear  as  if  by  magic,  when  the  causal 
associations  are  cleared  up.  It  is  as  if  the  patient, 
against  his  will  had  become  enmeshed  in  a  net  of  il- 
lusions,— it  needs  only  that  this  be  torn  asunder  in 
order  that  he  may  become  well  and  free.  He  has 
fled  from  reality;  but  the  neurosis  has  provided  a 
new  experience; — however  dangerous  reality  itself 
may  be,  there  is  one  thing  still  more  dangerous ;  and 
that  is  the  effort  to  assure  one's  self  against  it  in 
any  way  whatever. 

After  these  hints  concerning  Adler's  meaning  as  it 
has  to  do  with  neurotic  defense  mechanism,  I  shall 
point  out  briefly  what  is  involved  in  his  other  fun- 
damental idea,  viz,  "the  masculine  protest."  It  may 
be  most  suitable  to  start  from  a  concrete  case. 

A  robust  man  of  about  thirty  years  consulted 
me  once  because  of  impotence.  It  came  out  at  once 
that  the  impotence  applied  only  to  his  marriage ;  dur- 
ing the  whole  time  of  his  youth  he  had  been  unusually 
vigorous  in  the  sexual  respect.  He  had  married  sole- 
ly for  love  and  his  wife  was  in  no  way  opposed  to 
him.  This  seems  peculiar,  but  the  association  is  very 
simple.  I  asked  him  some  questions  concerning  his 
father  and  he  then  broke  out  with  the  greatest  bit- 
terness. His  father,  he  told  me,  had  ruined  his  life. 
All  through  his  student  days  this  father  had  dogged 


176      History  and  Practice  of  Psychanalysu 

his  steps  in  every  possible  way, — he  had  made  home 
a  perfect  hell  during  his  childhood,  etc.,  etc.  He 
continued:  "As  far  back  as  I  can  remember,  I  was 
determined  never  to  be  the  cause  of  bringing  children 
into  the  world, — I  Would  not  bring  about  such 
damnation  as  I  had  known  in  my  own  life."  Here 
was  the  thing  quite  clear.  The  young  man's  waking 
consciousness  in  childhood  had  been  impressed  with 
a  protest  against  the  father,  the  flame  being  con- 
tinually fed  by  new  feelings  of  hatred  which  must  be 
suppressed.  Out  of  this  protest  against  the  father 
arose  a  protest  against  fatherhood.  And  it  was  this 
which  brought  about  all  that  failure  of  the  sexual- 
mechanism,  when  danger  of  fatherhood  arose  because 
of  his  marriage.  I  asked  him  if  he  still  held  fast 
to  his  decision  not  to  wish  to  become  a  father.  "No, 
for  God's  sake!"  he  answered,  "My  wife  would  like 
ten  children  if  I  could  do  my  part."  Consciously 
then  he  had  given  up  the  protest.  In  such  cases  that 
is  always  the  first  step  toward  health.  Sometimes 
the  imprint  which  the  protest  puts  upon  the  uncon- 
scious mind  is  blotted  out  also:  but  if  this  is  deep- 
seated  it  may  require  tedious  work  to  repair  the  con- 
sequences of  the  past. 

In  this  case  it  is  easy  to  see  the  characteristics  of 
the  neurotic  attitude  toward  life.  In  the  face  of  the 
fact  of  an  unhappy  childhood,  the  sound,  strong 
man  says  to  himself:  "If  I  have  children  in  the 
future,  it  will  be  the  effort  of  my  life  to  see  to  it 


The  Adler-Doctrine  Concerning  Neurotis       177 

that  they  do  not  suffer  as  I  have  done."  This  is  a 
positive  goal;  it  is  something  which  at  the  same 
time  leaves  the  mind  open  for  what  is  to  come,  and 
which  gives  the  mind  a  content.  The  neurotic  on 
the  contrary,  flees  from  difficulties ;  the  impotence  is 
an  unconscious  stratagem,  by  means  of  which  this 
patient  had  beforehand  saved  himself,  without  the 
trouble  of  taking  hold  in  earnest  of  the  solution  of  a 
risky  problem.  Neurosis  is  the  negation  of  life.  The 
protest  is  the  active  side  of  this  negation.  The  pas- 
sive side  is  that  of  the  defense. 

This  protest-mechanism  opens  up  understanding 
for  very  many  neurotic  disturbances.  I  just  now  re- 
call a  man  who  suffered  from  the  same  trouble  as  the 
patient  I  have  last  mentioned;  he  had  been  left  be- 
hind by  his  competitors,  and  his  feelings  were  en- 
gulfed in  protest  against  this  unmerited  treatment. 
He  was  so  taken  up  with  thoughts  concerning  this 
occurrence,  that  he  never  had  time  to  devote  himself 
to  his  wife  and  his  home.  Another  patient  who  came 
to  me  for  treatment  for  alcoholism,  said  to  me:  "I 
notice  that  if  anyone  suspects  me  of  being  unable  to 
control  myself,  something  within  me  arises  in  protest 
and  I  go  and  get  drunk.  This  protest  is  more  dan- 
gerous for  me  than  anything  else." 

I  said  before,  how  the  neurotic,  unlike  the  degen- 
erate can  let  himself  be  carried  away  by  shadowy 
fantasies;  he  must  constantly  keep  hold  of  himself 
in  unavailing  effort  to  alter  the  reality  of  which  he 


178      History  and  Practice  of  Psychanalysls 

is  not  master.  The  protest  is  this  everlasting  re- 
bellion against  life,  which  leads  to  nothing  and  after 
which  the  neurotic  once  more  sinks  into  his  helpless- 
ness,— there  is  no  one  who  exhausts  his  forces  so  un- 
necessarily as  the  victim  of  a  protest-mechanism. 
The  so-called  neurasthenic  "tiredness"  is  often 
caused  by  simply  this. 

Adler  gives  the  protest  the  epithet  "masculine." 
This  means  that  all  the  struggling,  the  wish  to  be 
first  in  competition  with  others,  the  strife  for  power, 
which  characterize  the  mind-current,  has  to  do  with 
those  qualities  we  are  accustomed  to  call  masculine. 
But  there  is  also  another  and  more  important  rea- 
son. We  come  upon  the  protest  in  the  study  of  neu- 
rosis to  a  great  extent  and  in  a  special  form,  among 
women,  who  inwardly  rise  up  against  their  position 
as  women.  Behind  much  neurotic  suffering  among 
women  Adler  believes  that  he  is  able  to  see  the  hidden 
desire  to  escape  the  position  of  woman.  He  gives 
many  examples  of  women  who  ever  since  the  awaken- 
ing of  consciousness  have  been  in  open  strife  with 
their  sex,  and  who  react  with  anxiety,  insomnia  and 
other  symptoms  against  everything  which  reminds 
them  of  their  part  in  life.  This  is  not  so  strange  as 
it  may  appear.  Woman  since  the  earliest  days  of 
civilization  has  been  placed  in  a  subordinate  position ; 
one  might  almost  say  that  the  feeling  of  inferiority 
throughout  centuries  has  worked  into  womanhood  it- 
self and  now  burdens  the  whole  sex.  A  girl  becomes 


The  Adler-Doctrme  Concerning  Neurosis       179 

aware  of  this  disadvantage  as  soon  as  she  experi- 
ences the  condescending  airs  and  disdain  with  which 
her  brothers  talk  "of  girls  not  being  any  good."  Not 
at  all  strange  that  such  talk  awakens  a  desire  to 
out-shine  them.  But  in  this  very  fact  may  a  foun- 
dation be  laid  in  the  girl  for  a  conflict  with  her 
own  nature,  which  later  on  becomes  fatal.  The  pro- 
test, which  should  be  directed  against  what  is  fal- 
lacious in  the  opinion,  instead  directs  itself  against 
the  nature  of  womanhood  itself.  While  on  this  sub- 
ject it  might  be  a  temptation  to  see  how  Adler's 
point  of  view  holds  good  concerning  the  so-called 
feminist  movement.  Undoubtedly  he  believes  this 
movement  is  just,  as  a  means  of  rectifying  the  mis- 
takes of  the  history  of  civilization.  But  he  wonders 
if  it  does  not  sometimes  come  in  upon  paths  which 
have  relationship  with  those  of  illness,  where  occa- 
sionally a  woman  goes  astray,  because,  without  un- 
derstanding of  the  matter,  she  rises  in  arms  and  tries 
to  suppress  that  which  is  by  far  the  finest  and  noblest 
in  her  nature.  In  the  strife  after  "equality  with 
man"  alone,  lies  the  seed  for  one  such  way  of  stray- 
ing;— in  this  one  sees  an  inkling  of  the  "masculine 
protest,"  just  as  in  every  other  place  where  the 
woman  puts  forward  man  and  masculinity  as  an 
aim  for  her  struggle.  What  it  implies  is  not  that 
the  woman  shall  be  forced  into  the  same  plain  as  the 
man  and  have  opportunity  to  so  develop  her  powers 
that  she  shall  set  up  an  opposition  against  him ;  what 


180      History  and  Practice  of  Pst/cfi  analysis 

it  does  mean  is  that  she  must  be  freed  from  the  esti- 
mation and  standard  of  life  which  men  have  forced 
upon  her  and  thus  have  a  fair  chance  to  develop 
freely  and  fully,  her  own  nature. 

Anything  that  makes  an  early  straying  aside  upon 
any  one  of  these  many  wrong  paths  fatal,  is  the 
fact  that  the  individual  at  the  same  time  puts  before 
him  delusive  aims  and  fashions  his  life-plan  after 
these.  The  neurotic,  because  of  a  feeling  of  infer- 
iority, is  thus  separated  from  real  life  and  is  forced 
into  a  life  of  fantasy.  In  place  of  working  towards 
tangible  external  goals,  his  aim  is  after  something 
which  he  constructs  in  his  imagination.  He  thus  de- 
prives himself  of  the  happiness  that  lies  in  the  at- 
tainment of  something  after  which  he  has  struggled. 
He  stands  continually  in  front  of  the  painful  dis- 
covery that  his  own  fantasies  are  incongruous  with 
real  life.  "It  has  not  turned  out  as  I  expected  it  to," 
he  says.  "What  is  the  use  in  striving  for  anything?" 
and  so  his  activity  is  paralyzed  and  he  comes  into 
the  state  of  relaxation  of  will-power  so  characteristic 
of  the  neurasthenic. 

The  dangers  attending  the  building  up  of  these 
fictitious  ideas  against  which  the  neurotic  strives, 
are  simply  that  the  formation-process  itself  in  es- 
sential degree,  finally  is  decided  by  those  tendencies 
with  which  he  tries  to  compensate  the  feeling  of 
inferiority.  In  other  words:  the  whole  life-plan 
comes  to  be  decided  either  by  the  defense-mechanism 


The  Adler-Doctrine  Concerning  Neurosis       181 

or  the  protest.  In  order  to  leave  his  illusions 
behind  him  it  may  often  be  necessary  for  the  neurotic 
to  make  over  his  whole  life  from  the  very  foundation. 
Generally  the  so-called  regression,  plays  a  great  part 
in  every  treatment.  Through  this  something  like  a 
stop  is  put  to  that  development  in  which  the  indi- 
vidual is  being  driven  on  by  his  inner  forces.  He  is 
compelled  to  go  farther  and  farther  back  in  order 
to  review  every  point  in  life's  falsification,  to  which 
he  has  become  a  victim.  After  this  has  been  done 
he  comes  again  to  his  present  life  as  if  after  an 
inner  voyage  of  exploration;  he  sees  it  in  another 
light  and  comprehends  toward  what  genuine  purpose 
he  should  direct  himself. 

It  is  without  doubt  simply  in  the  ruling  of  the 
whole  life-plan  by  wrong  tendencies,  that  insurmount- 
able hindrances  often  arise  in  the  road  to  health. 

I  shall  here  give  an  example  of  what  I  mean. 

I  was  consulted  once  by  a  man  of  about  thirty 
years,  who  was  troubled  by  a  disturbance  in  the 
organ  of  speech.  He  did  not  stammer  exactly,  but 
suddenly  without  the  slightest  warning  the  tongue 
refused  to  do  its  service.  It  was  a  particularly  un- 
fortunate trouble  for  him  because  he  had  intended 
to  become  a  popular  lecturer.  He  had  put  before 
him  as  his  aim  in  life  the  elevation  of  the  people  and 
he  meant  to  stand  forth  himself  as  a  moral  example. 
Because  he  had  been  originally  a  poor  peasant  boy, 
and  gave  me  the  impression  of  being  orderly  and  dili- 


182      History  and  Practice  of  Psychanalysit 

gent,  but  nevertheless  exceedingly  poorly  gifted,  I 
suspected  at  once  that  there  was  a  plain  incongruity 
between  his  qualifications  and  his  ambition.  I 
thought  that  in  all  probability  the  trouble  with  the 
speech  had  some  dim  association  with  this  fact.  In- 
vestigation revealed  that  in  childhood  this  patient 
had  indulged  in  the  wildest  imaginations  connected 
with  war  and  plans  for  being  a  great  victor;  he 
wanted  to  eclipse  the  great  generals  of  his  country 
and  make  it  once  more  a  world  power,  etc.  As  soon 
as  he  was  grown  up  he  had  enlisted  in  the  army.  In 
this  act  there  was  nothing  peculiar.  But  he  had  by 
no  means  taken  this  course  with  the  thought  of  re- 
maining a  non-commissioned  officer  or  any  such  in- 
significant thing, — he  had  done  it  with  the  undis- 
turbed conviction  that  he  shortly  would  become  Chief 
of  the  General  Staff  and  in  this  position  would  be 
able  to  work  out  his  plans  as  soon  as  a  war  broke 
out.  Then  came  upon  him  the  trouble  with  his 
speech  which  forced  him  on  to  another  path.  He 
had  then  gone  to  New  Zealand.  "Why  New  Zea- 
land?" I  asked  him.  He  told  me  because  he  had 
wanted  to  say  that  he  had  been  farther  away  from 
his  native  land  than  any  one  else,  and  so  had  chosen 
the  point  on  the  globe  which  was  precisely  opposite 
his  own  country.  I  shall  not  repeat  all  the  queer  cir- 
cumstances with  which  this  analysis  swarmed.  Terse- 
ly, at  each  decision  he  allowed  himself  to  be  domi- 
nated by  his  childhood's  fiction  of  being  foremost. 


The  Adler-Doctrine  Concerning  Neurosis       188 

His  work  as  a  lecturer  was  naturally  nothing  else 
than  the  use  of  such  subjects  as  temperance,  the  edu- 
cation of  the  people  and  various  other  questions  of 
the  day,  in  order  to  attract  attention  to  himself, 
just  as  indeed,  many  others  use  such  means.  The 
disturbance  of  speech  had  arisen  as  a  natural  means 
to  try  to  force  him  to  fit  into  reality, — a  thing  I 
must  here  pass  by.  In  order  to  become  well  the  man 
had  to  give  up  his  ideas  of  greatness  and  be  resigned 
to  the  fact  that  he  was  entirely  an  every-day  unim- 
portant workman,  who  must  make  an  honorable 
means  of  self-support  his  purpose  in  life; — this 
change  was  too  much  for  him. 

In  referring  to  the  origin  of  inferiority,  I  touched 
upon  one  circumstance  which  puts  great  hindrances 
in  the  way  of  making  over  of  the  fictitious  life-plan, 
viz:  that  the  feeling  of  inferiority  itself  is  woven  in 
with  actual  physical  weaknesses  and  irregularities. 
These  thus  constantly  sustain  the  erroneous  mind- 
building  processes.  In  this  last  case  for  example, 
there  existed  a  malformation  of  the  gum  which  made 
it  hard  for  the  patient  to  pronounce  the  letter  "s." 

There  is  still  another  circumstance  which  in  this 
respect  is  of  even  greater  import  and  which  for  the 
sake  of  simplicity  I  have  hitherto  passed  by.  I  have 
to  presented  the  matter  that  it  would  seem  as  if 
the  feeling  of  inferiority  arose  in  connection  with 
physical  weakness  and  as  if  the  defense-  and  protest- 
mechanisms  originated  in  connection  with  those  dif- 


184      History  and  Practice  of  Psychanalysis 

ficulties  met  with  on  account  of  it,  in  the  fitting  in 
with  reality.  But  all  this  has  very  often  a  deeper 
association.  Anomalies  mean  psychic  educational 
faults,  and  it  is  against  these  that  compensation 
must  be  established  in  different  directions.  In  other 
words  the  individual  has  something  constitutional 
within  him  from  which  he  always  tries  to  escape  and 
against  which  he  continually  revolts.  Let  us  take  as 
an  example  a  homosexual  trait  in  a  deeply  moral  man 
of  strong  character.  Under  such  circumstances  a 
compulsion-neurosis  with  a  complicated  ritual  may 
be  erected,  which  forces  the  individual  every  second 
of  the  day  to  be  on  his  guard.  He  may,  for  in- 
stance, be  subjected  to  the  compulsion  of  dressing 
liimself  in  a  certain  way,  of  walking  upon  certain 
stones  in  certain  streets,  of  carrying  out  his  work  in 
a  certain  way, — he  may,  because  of  agorophobia,  be 
frightened  away  from  all  places  where  men  solicit, 
etc.  I  recall  one  man  of  splendid  education,  but 
constitutionally  homosexual,  who  joined  the  Salva- 
tion Army  and  for  whom  religion  played  the  part  of 
such  a  protecting  defense-measure.  Or  the  process 
may  also  appear  in  the  protest  form.  We  might  in 
that  case  say  that  the  protest  is  the  tension  between 
abnormal  tendencies, — such  as  perverted  animal  in- 
stincts, and  the  forces  in  use  in  the  construction  of 
morals.  The  more  one  is  reminded  of  the  impulse 
just  so  much  the  stronger  arises  the  protest;  this 
is  then  discarded  to  other  relativelv  indifferent  ob- 


The  Adler-Doctrine  Concerning  Neurosis       185 

jects  and  is  projected  into  the  surrounding  world 
and  into  work  in  accordance  with  well  known  mech- 
anisms. So  the  reason  which  causes  a  woman's 
shrewishness,  through  which  she  destroys  her  own 
happiness  as  well  as  that  of  others,  may  lie  in  some 
hidden  perversity,  from  which  she  continually,  by 
this  means,  tries  to  turn  her  attention. 

If  neurotic  conditions  do  not  become  amenable  to 
cure,  the  reason  will  often  be  found  in  such  con- 
stitutional anomalies,  which  make  the  fitting  into  real 
life  an  impossibility.  This  does  not,  however,  pre- 
clude the  possibility  that  the  situation  can  be  im- 
proved, that  is  to  say,  that  after  analysis  of  the 
associations  the  individual  can  replace  the  neurotic 
defense-system  with  something  better; — for  example 
replace  a  compulsion-system  that  paralyzes  the  whole 
working  power,  with  a  useful  work  which  holds  the 
attention  and  engrosses  the  energy. 

Such  deep  unchangeable  abnormalities  hold  good 
in  the  question  of  psychopathic  conditions.  For  the 
explanation  of  the  psychology  of  these  also,  Adler's 
lines  of  thought  have  value.  This  is  understandable 
if  one  keeps  in  mind  the  aim  toward  which  both 
fundamental  tendencies  point  most  surely; — these 
are  realized  in  both  the  extreme  psychic  types,  i.  e. 
in  the  dement  and  the  protest-paranoiac.  The  for- 
mer has  withdrawn  entirely  from  the  outside  world 
and  lives  only  in  the  fantasies  which  he,  himself 
produces.  He  has  shielded  himself  by  means  of  walls 


186      History  and  Practice  of  Psychanalysis 

built  up  from  the  compulsion-system,  symbols,  atti- 
tudes, automatisms,  etc.,  in  such  a  way  that  he  no 
longer  is  approachable.  The  latter,  on  the  contrary, 
instantly  takes  an  "on  guard"  attitude  toward  every 
one  he  meets.  He  is  oversensitive  in  regard  to  the 
outside  world  in  such  a  way  that  he  makes  use  of 
each  little  thing  as  a  welcome  means  of  obtaining 
outlet  for  the  hate-saturated  disharmony  within  him. 
Of  course  in  the  construction  of  psychopathic  con- 
ditions, causes  of  quite  another  sort  than  those  here 
described  also  come  into  question ;  with  them  medical 
psychology  has  nothing  to  do.  It  is  limited  to 
searching  into  psychological  associations. 

I  said  in  the  introduction  of  this  paper  that  Adler 
represented  a  revolt  against  the  Freud  system,  which 
sooner  or  later  must  have  come.  It  may  need  no 
more  than  the  above  hints  concerning  Adler*s  teach- 
ings to  make  clear  to  every  one  how  widely  they  dif- 
fer from  everything  that  is  connected  with  the  name 
of  Freud.  Obviously  a  presentation  of  everything, 
which  according  to  Adler  is  fundamentally  important 
for  the  construction  of  neurosis,  may  be  given,  with- 
out once  bringing  the  sexual  life  into  question.  In 
his  earnestness  to  point  out  other  causes  than  those 
emphasized  by  Freud,  he  has  even  gone  so  far  as 
wholly  to  deny  that  the  sexual-life  and  its  conflicts 
are  explanatory  foundations  for  nervous  suffering. 
It  may  appear  of  only  paradoxical  interest.  But 
really  that  is  the  conclusion  we  must  arrive  at,  if 


The  Adler-Doctrine  Concerning  Neurosis       187 

Adler's  opinions  are  followed  out  to  the  goal  toward 
which  they  point.  And  Adler  may  be  accused  of 
anything  rather  than  of  inconsistency. 

The  forces  which  Adler  pointed  out,  and  the  action 
of  which  he  tried  to  follow  in  detail,  play,  accord- 
ing to  him,  such  a  dominating  role,  that  the  sexual- 
life  itself,  by  the  side  of  them,  steps  into  the  back- 
ground. Where  the  feeling  of  inferiority  has  found 
a  way  into  a  person's  life  everything  must  yield  to 
the  effort  to  build  up  compensation  in  one  way  or 
another, — everything  is  subordinated  to  this,  even 
the  longing  to  reach  freedom  of  the  senses.  Before 
the  purpose  of  defending  one's  self  against  the  dan- 
gers of  life,  or  the  longing  to  overcome  other  dangers 
by  means  of  the  masculine  protest,  the  neurotic  loses 
sight  of  all  other  purposes.  He  not  only  loses  love  as 
an  aim  in  life,  but  he  loses  the  faculty  itself,  to  love. 
He  meets  every  rising  tendency  within  himself,  with 
an  anxious  effort  to  flee  from  it.  He  dare  not  de- 
vote himself  to  anything  which  may  bring  him  in 
contact  with  this  dangerous  reality,  which  is  his  con- 
stant terror.  Love  would  compel  him  to  give  up 
those  dreams  which  are  dearer  to  him  than  life,  and 
drive  him  to  the  humiliating  acknowledgment  that  he 
has  striven  after  an  illusory  goal ; — so  must  he  raise 
himself  up  in  protest  against  it.  Because  of  this 
everlasting  seeking  after  fictitious  aims,  after  un- 
reality, the  neurotic  can  never  give  himself  up  to  the 
risk  of  a  real  emotion,  as  he  must  do,  if  by  means 


188      History  and  Practice  of  Psych  analysis 

of  it  he  is  to  redeem  himself.  All  that  has  to  do  with 
the  erotic,  remains  for  him  just  as  unreal  as  every- 
thing else  in  his  life, — a  fantasy,  an  arrangement,  a 
pose,  a  part  to  play.  Because  of  this  Adler  believes 
that  it  is  preposterous  to  ascribe  such  a  causal  sig- 
nificance to  neurosis-formation,  even  where  the  pa- 
tient himself  shoves  such  significance  into  the  fore- 
ground and  when  at  superficial  consideration  it  seems 
to  play  a  chief  part.  The  deciding  factors  are,  in- 
stead, all  those  things  which  drive  the  neurotic  into 
a  life  of  unreality  and  impede  his  emancipation. 

Even  if  Freud's  sexual-doctrine  may  not  be  elim- 
inated from  scientific  consciousness  in  so  convenient 
a  way,  Adler's  point  of  view  contains  nevertheless 
very  much  of  value.  It  can  not  be  denied  that  the 
"libidinous  satyr-play"  is  often  an  external  phenome- 
non, deep  under  which  "the  tragedy  of  the  masculine 
protest"  works  the  destruction  of  the  individual. 
Strindberg,  whose  life  and  work  are  an  inexhaustible 
well-spring  for  the  exemplification  of  Adler's  view- 
point is,  in  this  regard,  singularly  instructive.  One 
of  Adler's  most  faithful  adherents,  Freschl,  has  re- 
cently devoted  himself  to  a  study  of  Strindberg's 
book,  "For  Pay."  This  points  out  how,  for  the 
author,  everything  was  a  question  of  power,  an  effort 
to  demonstrate  his  superiority.  He  feels  his  in- 
feriority in  regard  to  woman  and  marries  three  times 
in  the  hope  of  finally  becoming  master  over  some  one. 
At  the  bottom  of  his  inclination  to  endow  woman  at 


The  Adler-Doctrme  Concerning  Neurosis       189 

one  and  the  same  time  with  irresistible  charm  and 
with  the  most  horrible  qualities,  lies  one  of  those 
strange  stratagems  which  are  so  often  met  with  in 
neurotics ;  he  does  it  to  protect  himself  from  the 
humiliation  which  otherwise  would  mean  his  going 
under  in  the  battle  against  her,  for  no  one  need  be 
ashamed  of  being  unable  to  withstand  such  mon- 
sters of  artifice  and  enchantment  as  he  makes  his 
fictitious  women  appear  to  be. 

Helen  must  conquer  in  order  to  show  the  danger- 
ous power  of  which  she  is  possessed  and  it  is  easy 
to  understand  the  need  of  the  man  to  protect  himself 
against  her, — against  women — etc.  Out  of  Strind- 
berg's  life  and  out  of  all  his  books  it  is  easy  to  see 
how  aggression-tendencies  originated  from  a  neu- 
rotic thought-scheme  to  which  he  must  keep  fast  hold 
in  order  to  defend  himself,  since  he  plainly  felt  how 
great  was  his  insecurity  against  women.  This  feel- 
ing of  powerlessness  in  the  struggle  against  her,  was 
however,  only  one  expression  standing  out  in  the  fore- 
ground, for  a  general  feeling  of  inferiority  which  he 
had  with  him  from  the  very  beginning. 

When  Strindberg  speaks  of  love  between  man 
and  woman,  it  does  not  mean  anything  like  love,  but 
only  the  question  which  of  the  two  shall  get  the 
better  of  the  other  in  the  struggle  for  power. 

This  has  interest  in  showing  how  Adler  thus  throws 
new  light  upon  a  problem  which  Freud  believed  he 
had  made  quite  clear  in  the  gleam  from  his  dark- 


190      History  and  Practice  of  Psyclianalysis 

lantern  of  sexual  dogmatism.  Through  it  there  has 
come  about  a  re-valuation  of  all  those  facts  which 
Freud  dragged  forth  and  made  subjects  for  dis- 
cussion. The  most  important  question  is  the  manner 
in  which  Adler  manages  the  incest-doctrine.  As  I 
pointed  out  in  the  foregoing  paper,  during  the  de- 
velopment of  psychanalysis  this  doctrine  has  become 
such  an  absolute  center  in  the  whole  structure  of 
the  teaching,  that  it  often  seems  as  if  an  answer  to 
all  the  fundamentally  essential  questions  seek  de- 
duction out  of  it.  Adler's  greatest  import  lies  per- 
haps simply  in  the  fact  that  he  constructed  a  dam 
against  the  inclination  of  this  incest-doctrine  to  over- 
flow all  the  different  spheres  of  human-nature. 

The  material  for  the  incest-doctrine  has  been 
chiefly  gathered  from  dreams.  It  can  neither  enter 
Adler's  mind  nor  that  of  anyone  else  who  is  prac- 
tically engaged  with  psychology,  to  deny  that  in  the 
dreams  of  neurotic  patients  incestuous  fantasies  are 
to  be  met  with  about  as  Freud  describes  them,  and 
that  through  analysis  one  may  find  a  trace  of  such 
things  in  the  unconscious  life  of  everyone.  The  ques- 
tion therefore  is  not  so  much  this  fact  in  and  for 
itself,  but  far  more  how  it  shall  be  explained.  The 
opposition  which  arose  was  chiefly  against  Freud's 
manner  of  interpreting  it  as  an  expression  of  an 
unconscious  wish,  which  prevented  free  play  of  the 
feelings  and  gave  rise  to  insuperable  resistance 
against  those  forces  which  will  out.  What  Adler 


The  Adler-Doctrine  Concerning  Neurosis       191 

above  all  objected  to  was  the  establishment  of  the 
incest-motive  as  a  reality  in  the  life  of  the  indi- 
vidual. When  he  himself  accepts  the  erotic  conflict 
in  neurotics  as  an  unreality, — as  a  curtain,  behind 
which  all  these  other  forces  are  acting ;  then  it  is  but 
a  step  for  him  also  to  accept  the  origin  of  those  con- 
flicts as  an  illusion,  a  self-deception.  He  also  con- 
sidered it  only  as  a  staging  of  the  longing  for  pro- 
tection and  the  struggle  for  power.  When  the  man, 
for  instance,  dreams  that  he  is  in  intimate  inter- 
course with  his  mother,  it  means  only  that  he  runs 
to  her  from  the  dangers  of  life  in  the  same,  way  he 
did  as  a  child.  And  so  it  is  always.  The  fact  that 
these  sensuous  situations  appear  in  dreams  so  rela- 
tively often,  depends  most  closely  upon  a  technical 
circumstance  in  the  formation  of  dreams.  We  pos- 
sess in  the  unconscious  mind,  so  to  speak,  a  stratum 
of  memory  pictures  which  superimposes  an  earlier 
stadium  in  connection  with  the  most  primitive  sensu- 
ous sensations.  Among  these  memories,  pictures  of 
our  nearest  relations  play  the  chief  role, — they  being 
then  the  only  individuals  who  existed  for  us.  Of  the 
psychic  material  furnished  by  this  stratum,  we  make 
use  in  dreams  in  order  to  express  those  tendencies  by 
which  our  conscious  ego  is  ruled;  we  need  this  to 
illustrate  endeavors  of  quite  another  sort. 

It  seems  to  me  that  Adler  is  right  in  that  the 
incest-material  must  not  be  taken  so  seriously  as 
Freud  took  it.  But  on  the  other  hand  I  do  not  be- 


192      History  and  Practice  of  Psi/ch  analysis 

lieve  that  the  question  can  be  solved  according  to 
his  psychological  outlines ;  it  must  be  considered  in 
a  broader  connection,  much  broader  than  could  here 
even  be  sketched  in. 


But  the  strife  which  is  now  going  on  between 
Freud  and  Adler  means  far  more  than  scientific  con- 
troversies like  those  upon  which  I  have  touched; 
it  means  even  more  than  the  ground  work  for  medical 
psychology. 

I  pointed  out  in  the  beginning  that  Freud  tried 
to  interpret  the  psychic-life  from  its  causal  assump- 
tions, just  as  every  investigator  of  natural  science 
interprets  phenomena  which  come  within  his  field 
of  research.  The  basic  idea  in  the  sexual  doctrine 
is  simply  such  an  attempt  to  resolve  all  different 
expressions  of  the  mental  life  into  more  or  less  ac- 
cidental forms,  by  the  power  which  rules  the  whole 
of  the  animal  world.  Freud's  attempt  aims,  in  other 
words,  to  fit  the  teaching  concerning  the  mental  life 
in,  with  all  the  rest  of  the  system  of  natural  science. 
Adler's  opposition  is  an  expression  of  humanity's 
everlasting  protest  against  all  under-valuation  of 
the  specifically  human  forces;  it  is  the  claim  of 
the  final  view  point  on  an  equality  with  the  causal. 

It  may  thus  be  seen  that  Adler  asserts  finality  with 
that  same  ruthless  one-sidedness,  with  which  Freud 


The  Adler-Doctrine  Concerning  Neurosis      193 

emphasized  causality,  as  the  driving,  creating,  power 
in  human  life. 

According  to  Adler  we  understand  nothing  of  that 
which  takes  place  within  us  unless  we  first  and  fore- 
most direct  attention  to  the  ineffaceable  struggle 
after  a  purpose  which  rules  all  our  undertakings. 
The  nature  of  neurosis  is  unveiled  to  us  only  when 
we  learn  to  distinguish  between  real  and  illusory 
aims.  If  this  struggle  for  a  purpose  comes  from 
within  and  carries  with  it  the  stamp  of  our  deepest, 
truest  volition, — if  the  purpose  is  in  harmonious 
proportion  with  our  forces  and  if  its  attainment  leads 
to  the  emancipation  of  these  forces,  then  we  are  on 
the  right  road.  But  if  the  effort  itself  is  distorted, 
excited,  and  really  an  egotistical  desire  to  demon- 
strate our  own  superiority;  if  the  purpose  is  some- 
thing which  in  actuality  we  do  not  desire,  some- 
thing, which  looked  deeper  into,  is  of  no  worth  to 
us,  a  will-o-the-wisp  after  which  we  reach  only  be- 
cause it  shines  beautifully  before  our  eyes, — then 
we  are  on  the  road  to  disease. 

Behind  this  struggle  toward  a  goal  Adler  catches 
a  gleam  of  the  permanent  life-plan.  The  idea  for 
him,  carries  with  it  almost  a  mystical  purport,  and 
in  reading  his  works  one  sometimes  feels  that  this  idea 
is  his  name  for  the  substance  of  life  itself.  To  show 
how  deeply  the  life-plan  is  grown  into  the  psyche, 
he  has  investigated  the  earliest  memories  of  child- 
hood in  a  very  large  number  of  cases;  he  has  found 


194?      History  and  Practice  of  Psychanalysis 

thereby  that  these  always  are  a  symbol  of  the  life- 
plan.  As  an  instance,  I  questioned  a  young  man 
about  his  earliest  recollections ; — he  had  sat  upon 
somebody's  knee  and  told  tales  of  robbers  and  had 
been  overjoyed  when  some  of  the  people  near  him 
expressed  delight.  He  was  then  three  years  old. 
Now  he  is  over  twenty  and  wants  to  study  to  become 
an  artist ;  his  life  is  ruled  by  the  longing  to  charm 
in  some  such  capacity,  his  contemporaries.  The  life- 
plan  is  the  indwelling,  primitive,  central  point  in  the 
human  soul.  Life  consists  of  an  effort  to  realize  it. 
In  front  of  it  everything  else  must  give  way,  and  to 
it  all  other  tendencies  must  be  subordinated. 

Adler's  undisturbed  consistency  comes  out  strong- 
est by  far  in  the  way  in  which  he  puts  another  con- 
struction on  the  Freud  incest-doctrine.  Even  the 
forces  which  penetrate  most  deeply  into  the  assump- 
tions of  our  earthly  existence  are  not,  according  to 
Adler,  decisive  for  the  form  of  it.  By  themselves 
they  are  empty,  illusory.  Their  real  import  is  dis- 
covered only  when  they  are  seen  in  connection  with 
the  life-plan ;  that  is  the  substance  which  fills  out 
these  forces  with  real  content,  which  negotiates  their 
associations  with  reality  in  general. 

It  may  seem  as  if  an  insurmountable  wall  separates 
that  which  Freud,  and  Adler,  represents,  each  in  his 
own  way,  and  as  if  their  most  zealous  disciples  were 
right  in  proclaiming  that  one  must  take  sides  in  the 


The  Adler-Doctrine  Concerning  Neurosis       195 

question.  As  the  attempt  to  couple  the  two  views 
together  has  been  hitherto  unsuccessful,  it  will  in  all 
probability  show  itself  to  be  useless  later  on. 

But  if  a  broader  view  of  the  matter  is  taken,  the 
situation  changes  and  we  find  that  both  fundamental 
opinions  are  only  two  different  standpoints  from 
which  the  whole  may  be  considered. 

In  choosing  a  point  of  outlook  over  all  the  grow- 
ing phenomena  of  life,  it  is  necessary  to  choose  one 
which  under  all  circumstances  remains  undisturbed. 
It  is  necessary  to  take  fast  hold  of  a  fact,  the  surety 
of  which  can  never  even  be  brought  into  discussion 
and  which  at  the  same  time  has  such  radical  impor- 
tance that  it  always  must  be  kept  in  mind.  There 
are  in  reality  only  two  such  facts  as  these.  The 
first  is,  that  we  all  are  born  of  woman  and  the 
second,  that  all  must  some  time  die. 

If  Freud's  incest-doctrine  is  stripped  of  all  its 
scientific  adornment  and  disengaged  from  all  its  mis- 
leading terminology,  it  is  seen  that  the  kernel  of  it 
all  is  nothing  but  a  presentation  of  this  first  fact. 
The  way  itself,  in  which  we  come  into  life,  is  so  in- 
timately bound  up  with  material  forces,  that  these  in 
their  entirety,  must  remain  stamped  by  it.  It  im- 
plies a  bondage  from  which  we  are  unable  to  make 
ourselves  free,  we  cannot  even  become  wholly  loosed 
from  that  form  in  which  the  bondage  primarily  was 
moulded.  All  experiences  may  be  arranged  under 


196      History  and  Practice  of  PsycJianalysis 

this  category  as  Freud  has  arranged  them; — and 
thus  one  will  arrive  at  his  one-sided  assertion  of 
causality. 

On  the  other  hand  all  the  final  tendencies  of  the 
world's  view  point  are  woven  into  the  fact  that  we 
shall  some  time  stand  before  the  inevitable;  finis. 
Just  as  consciousness  that  the  day  comes  to  a  close 
within  a  certain  period  of  time,  forces  us  to  ar- 
range, so  that  we  finish  what  we  ought  and  wish  to 
do  within  that  time,  so  the  constant  nearness  of  the 
fact  of  death  in  our  consciousness,  forces  us  to  con- 
trive our  lives  after  certain  directing  lines.  We 
must  so  establish  ourselves  that  sometime  we  shall 
with  dignity,  be  able  to  leave  our  lives  behind  us, 
a  work  completed.  So  strong  is  this  need  that  we 
cannot  withdraw  one  single  moment  of  our  lives  from 
under  its  dominion ;  we  thus  arrange  all  occurrences 
in  accordance  with  this  fact. 

As  all  in  our  lives,  of  which  we  have  any  knowl- 
edge, falls  as  to  time,  between  two  points,  birth  and 
death,  so  everything  we  think,  desire,  feel,  bears  the 
imprint  of  both  these  fundamental  facts ;  all  is  a 
struggle  between  forces  whose  origin  predominates 
in  one  or  the  other  direction.  Any  genuine  under- 
standing of  that  which  we  experience  and  of  our  posi- 
tion in  life  in  its  totality,  we  may  arrive  at  just  as 
little  on  one  as  on  the  other,  of  these  one-sided  paths. 
As  warped  and  unreal  as  a  fact  appears  when  illu- 
minated exclusively  from  the  viewpoint  of  birth,  just 


The  Adler-Doctrme  Concerning  Neurosis        197 

as  warped  and  unreal  does  it  appear  when  light  shines 
upon  it  only  from  the  opposite  direction. 

However  many  valuable  contributions  to  our 
knowledge  Adler's  doctrine  concerning  neurosis  has 
given  us,  on  the  whole  it  seems  to  me  as  little  able  to 
serve  as  a  foundation  for  the  needs  of  psychotherapy, 
as  the  Freud  system  itself. 


THE  NATURE  OF  HYPNOSIS 

DURING  the  course  of  a  practice  which  has 
given  me  opportunity  to  observe  the  phenomena 
of  hypnosis  about  twenty  thousand  times,  I  have 
more  and  more  separated  my  own  thought  from  that 
of  the  general  opinion  concerning  its  nature.  Above 
all,  I  have  lost  sympathy  with  Bernheim's  dictum: 
"il  n'y  a  pas  d'hypnose,  il  n'y  a  que  la  suggestion." 
That  this  phrase  won  such  strong  approbation,  seems 
to  me  to  depend  upon  the  fact,  that  it  simplified 
to  an  inexpressible  degree  a  very  difficult  problem. 
During  the  century  that  elapsed  after  the  discovery 
of  the  peculiar  condition  now  called  hypnosis,  in- 
numerable investigators  endeavored  to  find  an 
explanation  of  it  nature.  When  therefore,  the  fore- 
most representative  of  this  branch  of  research  de- 
clared emphatically  that  the  objective  point  for  his 
research,  generally  speaking,  did  not  exist,  it  came 
as  a  kind  of  relief.  After  that  no  one  need  trouble 
his  brain  to  find  further  solution  of  the  question ;  the 
whole  theme  could  calmly  be  left  where  it  was. 
How  obstructive  this  phrase  of  Bernheim's  has  been, 

198 


The  Nature  of  Hypnosis  199 

not  only  to  the  development  of  the  subject  itself, 
but  also  to  the  use  of  hypnosis  on  the  practical  side, 
is  easily  to  be  seen  if  the  literature  is  gone  through. 
It  will  probably  be  difficult  to  find  anyone  who  went 
farther  in  hypnotic  research,  without  letting  himself 
be  influenced  by  this  stumbling  block  in  the  path  than 
Wetterstrand.  For  him  hypnosis  always  remained  a 
unique  psycho-physiological  condition,  that  must 
neither  be  confused  with  sleep  nor  with  the  waking 
state,  and  which,  irrespective  of  all  suggestion,  had  a 
high  therapeutic  value.  Even  if  suggestion  plays  a 
certain  role  in  the  production  of  this  condition,  it 
can  be  called  suggestion  here  just  as  little  as  in 
sleep  or  in  death.  This  idea  was  the  foundation  for 
that  method  of  treatment  which  Wetterstrand  called 
"The  Prolonged  Sleep"  and  with  which  he  undoubt- 
edly achieved  amazing  results.  How  far  we  have 
come  away  from  progress  in  this  direction,  is  best 
shown  in  the  fact  that  Wetterstrand  got  no  fol- 
lowers in  his  own  method.  I  shall  not  here  refer  to 
the  old  controversy ;  I  have  mentioned  it  thus  briefly^ 
merely  to  signify  that  I  am  myself  most  closely 
joined  to  Wetterstrand's  out-of-date  standpoint  on 
this  question.  But  for  him  also,  as  with  the  earlier 
investigators,  hypnotism  was  always  veiled  in  a  cer- 
tain mystical  vagueness.  The  purpose  of  this  paper 
is  to  point  out  with  the  greatest  possible  brevity,  how 
for  me  it  has  lost  this  mystical  stamp. 

In  order  to  get  a  clear  picture  of  hypnosis,  I  have 


200      History  and  Practice  of  Psychanalysis 

at  various  times  asked  patients  to  give  me  a  short 
and  accurate  description  of  what  they  felt  while  in 
the  hypnotic  condition.  It  seems  to  me  better  to  take 
up  here,  one  such  description  rather  than  a  general 
collection  of  different  experiences.  The  following 
was  written  by  a  woman  of  forty,  whom  I  had  under 
treatment  for  nervous  vomiting  and  insomnia.  She 
was  intelligent,  had  read  much,  but  knew  nothing 
about  hypnotic  literature;  what  she  wrote  was  de- 
rived directly  from  her  own  experience. 

The  first  sensation  of  the  psychic  action  is  one 
of  calm;  every  disturbing  thought  disappears  and 
instead  comes  an  impression  of  quietness  that  seems 
entirely  physical.  Every  muscle  relaxes  and  the  eyes 
close  almost  involuntarily.  Little  by  little,  all  per- 
ception of  time  disappears.  That  is  the  only  thing 
which,  from  the  beginning,  one  almost  entirely  loses. 
All  sounds  are  heard  as  from  a  distance  and  a  peace- 
ful feeling  of  rest  falls  upon  one  mentally  and  phys- 
ically. But  this  is  of  one's  own  free  will,  the  feeling 
that  one  has  one's  self  in  hand  need  not  disappear  for 
an  instant ;  one  can,  if  one  wishes,  think  quite  clearly, 
open  the  eyes  if  one  desires,  hear  what  is  said  or  what 
takes  place  nearby  (unexpected  noises  one  always 
hears),  move  as  one  desires,  but  one  can  also  let  all 
thoughts  go  and  lie  quite  motionless.  It  is  a  matter 
of  the  will  from  the  patient's  side.  Finally  there 
comes  the  most  wonderful  sensation,  a  feeling  of  con- 
centration of  one's  self  within  one's  body,  as  if  one 
were  isolated  within  one's  self.  Everything  disap- 
pears, only  the  I  consciousness  is  left.  This  con- 


The  Nature  of  Hypnosis  201 

centration  is  like  the  most  absolute  rest  one  can 
imagine.  When  this  condition  is  reached  it  must  be 
acknowledged  that  it  requires  a  very  great  effort  of 
will  in  order  to  think,  move,  or  even  open  the  eyes; 
it  is  possible  to  do  it,  but  there  is  no  desire.  If  a 
trial  is  made  to  move  or  think,  regret  quickly  fol- 
lows and  one  makes  haste  to  sink  back  again  into 
this  Nirvana  where  one  really  loses  neither  conscious- 
ness nor  individuality,  but  finds  the  most  delightful 
rest  than  can  be  dreamed  of.  Then  after  the  treat- 
men  ceases,  in  the  first  few  moments,  one  feels  sleepy 
and  unwilling  to  open  the  eyes,  but  after  a  very  short 
period  this  desire  to  sleep  disappears  and  one  feels 
rested,  alert,  as  if  even  the  thought  faculty  had  been 
sharpened  and  both  mental  and  physical  forces 
strengthened. 

I  have  said  that  this  patient  was  unacquainted 
with  hypnotic  literature.  I  must  add  that  at  the  time 
of  this  written  descripion,  she  had  never  been  in- 
fluenced by  my  suggestions.  When  I  find  hypnosis 
induced,  it  is  my  practice  to  permit  it  to  develop 
as  freely  as  possible;  in  advance  I  merely  dispel 
false  ideas  regarding  it,  especially  the  common  belief 
that  it  means  a  condition  wherein  consciousness  is 
lost. 

In  this  description  however,  those  characteristic 
features  appear,  which  are  found  in  all  descriptions 
and  which  must  start  either  from  an  earlier  period 
of  time  or  from  the  animal  magnetism  period;  ad- 
mitting that  these  descriptions,  especially  those  from 


202      History  and  Practice  of  Psychanaly&is 

the  former  state,  often  are  personally  and  even  fan- 
tastically colored,  there  are  nevertheless  always  some 
signs  that  are  unmistakable.  If  it  had  to  do  only 
with  the  product  of  imagination,  this  unity  would  be 
hard  to  explain;  it  appears  to  me  to  show  that  it 
indicates  a  condition  sui  generis,  which  different  peo- 
ple experience  pretty  much  alike  and  of  which  in  the 
attempt  at  description  each  one  takes  hold  in  his  own 
way. 

For  the  sake  of  simplicity  I  shall  point  out  only 
five  characteristic  points. 

1.  That  which  to  the  patient  was  most  obvious, 
was  the  fact  that  consciousness  was  retained,  al- 
though single  objects  disappeared  out  of  it.  The 
psychologist  is  at  once  ready  to  object  that  this  is 
not  possible.  To  all  intents  and  purposes  indeed, 
consciousness  disappears,  according  to  all  our  or- 
dinary experiences,  at  the  moment  we  cease  to  occupy 
ourselves  with  a  specific  thing.  If  during  the  night 
we  waken  for  a  moment  from  sleep,  we  only  realize 
something  of  it  because  of  the  dream-pictures  which 
at  the  instant  glided  past  us.  And  yet  it  cannot  be 
denied  that  a  true  observation  lies  at  the  bottom  of 
the  patient's  description.  I  have  often  from  different 
patients,  heard  the  word  Nirvana ;  is  not  this  meant 
to  signify  a  disappearance  of  all  the  world,  with- 
out the  cessation  of  life  because  of  that  disappear- 
ance ?  Admitting  that  such  a  thing  cannot  be  wholly 
realized,  in  hypnosis  there  is  however  a  tendency  in 


The  Nature  of  Hypnosis  203 

that  direction  which  never  has  been  carried  into 
effect,  to  quite  so  great  a  degree,  in  any  other 
way. 

2.  The  patient  pointed  out  a  peculiar  feeling  of 
concentration  within  herself;  a  kind  of  flowing  to- 
gether of  all  that  energy  which  generally  is  divided 
between  the  common  affairs  of  the  world,  the  self, 
the  patient's  own  body — i.  e.  the  isolating  of  the 
individual    within    himself.     The    phenomenon    was 
plain   to   Liebeault,   when  he   founded   the  modern 
theory  of  hypnosis.     He  laid  stress  upon  the  way  in 
which  the  attention  draws  itself  back  from  those 
things  within  the  physical  sphere,  and  thus  becomes 
accumulated  in  the  brain  ("!'  accumulation  de  1'at- 
tention" )  : — he  explained  the  pathologic  and  thera- 
peutic phenomena  as  a  directing  and  concentrating 
of  the  attention  of  the  patient,  who  had  thus  been 
made  free. 

3.  If  one  takes  as  a  point  of  procedure  this  specific 
isolating  within  itself  of  the  organism,  the  psychic 
changes   during  hypnosis   become   easier  to   under- 
stand.    These  have  been  looked  upon  as  phenomena 
of  suggestion  (by  Hirschlaff  and  others),  but  this 
idea  does  not  fit  in  with  my  own  experience.     Even 
if  these  changes  could  be  intensified  suggestively  in 
different  directions,  there  is,  nevertheless,  in  hypnosis 
a  kind  of  spontaneous  preparation  for  them,  to  which 
this  intensification  is  added.     The  condition  of  hyp- 
nosis means  a  partial  cutting  off  of  connection  with 
the  outside  world,  which  spontaneously  carries  with 


204)      History  and  Practice  of  Psychanalysis 

it  a  decline  of  the  mental  functions.  Subjectively 
this  is  bound  up  with  a  feeling  which  every  one  who 
has  experienced  it,  is  reluctant  to  give  up.  It  is  de- 
scribed generally  as  a  sensation  of  heaviness,  which 
commonly  starts  in  the  feet  and  afterwards  spreads 
over  the  whole  body,  until  the  patient  finally  lies  as  if 
paralyzed.  A  colleague  whom  I  treated  for  mor- 
phinism, characterized  this  sensation  more  as  one  of 
pressure,  which  from  every  side,  acted  upon  the 
body.  He  found  this  sensation  so  typical,  that  he 
had  the  impression  that  hypnosis  could  be  induced 
in  this  way;  that  is  to  say,  by  applying  to  various 
parts  of  the  body  tightly  pressing  weights,  so  that 
the  fundamental  idea  of  hypnosis  might  be  sug- 
gested into  the  consciousness  and  then  hypnosis  itself 
would  appear  by  means  of  associated  reflexes.  Ob- 
jectively this  sensation  of  weight  or  pressure  cor- 
responds to  that  of  catalepsy.  Characteristic  to  it 
(as  may  be  observed  from  the  written  description 
cited),  is  rather  a  disinclination  to  move  than  an 
inability  to  do  so;  in  other  words,  the  motionless 
state  is  here  natural  and  may  be  overcome  only  by  a 
disagreeable  exertion  of  energy. 

4.  Further  I  must  mention  the  automatism,  al- 
though this  appears  only  indirectly  in  the  description 
cited.  This  has  always  been  considered  as  a  real 
characteristic  of  the  deep  sleep.  The  disinclination  to 
move  develops  into  an  aversion  towards  all  changes ; 
a  movement  which  has  been  started  from  without,  is 


The  Nature  of  Hypnosis  205 

thus  permitted  to  continue  without  effort  to  inter- 
rupt it.  But  it  is  of  greater  importance  that  the 
automatism  of  the  physiological  functions  is  rein- 
forced during  hypnosis.  In  ordinary  circumstances 
these  are  easily  disturbed  by  innumerable  things 
which  aggravate,  in  both  a  physical  and  psychic 
way;  when,  during  hypnosis,  all  these  things  fall 
away,  a  regulating  of  the  bodily  functions  sets  in, 
which  for  the  understanding  of  the  therapeutic  value 
of  hypnosis  is  of  the  greatest  importance. 

5.  In  the  description  cited  the  patient  time  after 
time  reached  this  typical  state  of  rest.  And  it  is  a 
point  upon  which  much  stress  is  laid  in  all  other 
descriptions.  Just  as  in  this  description,  the  impres- 
sion is  continually  given,  that  it  signifies  a  sensation 
which  only  to  a  small  degree  can  be  characterized  by 
the  word,  rest;  that  it  means  something  for  which 
speech  has  no  word — and  this  for  the  simple  reason 
that  it  has  no  existence  in  ordinary  life.  In  practice 
the  word  sleep  must  perforce,  be  made  use  of;  but 
this  unfortunately  always  brings  about  a  misunder- 
standing. 

The  study  of  hypnosis  is  made  much  more  difficult 
because  it  very  seldom  appears  in  its  pure  form.  In 
general  practice  what,  as  a  rule,  is  observed,  is  only 
one  or  the  other  of  the  above  mentioned  features,  sup- 
plementing the  waking  condition.  If  the  state  of 
hypnosis  becomes  deeper,  sleep  struggles  to  take 
control,  and  the  result  is  either  one  or  another  cross- 


206      History  and  Practice  of  Psychanalysis 

ing  with  that.  If  hypnosis  is  to  be  seen  in  a  purer 
form  it  is  necessary  above  all  to  strive  after  it.  To 
be  convinced  that  this  purer  form  does  not  exist  and 
to  be  influenced  in  one's  work  by  this  conviction  is 
sufficient  reason  for  never  observing  it.  So  it  is 
possible  to  see  very  little  of  it  if  one,  like  Hirschlaff 
for  example,  gives  on  an  average  of  only  ten  minutes 
for  each  seance;  for  in  so  short  a  time  it  is,  as  a 
rule,  impossible  to  produce  the  deeper  state  of  hyp- 
nosis. A  much  longer  time  must  be  counted  upon  if 
one  wishes  to  become  convinced  of  its  therapeutic  ac- 
tivity. I  have  very  often  had  opportunities  to  ob- 
serve how  various  pains,  cramps  and  other  neurotic 
symptoms,  which  have  not  been  influenced  by  an 
hour's  hypnotic  treatment,  disappear  after  two  or 
three  hours.  However  it  is  not  my  intention  to  take 
up  here  the  therapeutic  side  of  the  question.  That 
demands  particular  work  in  the  discussion  of  dif- 
ferent cases,  in  order  to  separate  the  results  of  hyp- 
nosis from  those  of  suggestion.  So  far  as  I  under- 
stand it,  the  idea  of  suggestion  must  be  stretched 
out  until  it  becomes  all-inclusive,  if  a  specific  cura- 
tive action  in  hypnosis  alone  is  to  be  denied; — but 
with  any  such  extension  of  an  idea,  science  comes  to 
an  end. 

Before  I  set  forth  my  opinion  concerning  the  na- 
ture of  hypnosis  I  must  make  plain  a  few  points 
about  the  manner  of  inducing  it,  by  the  aid  of  which 
I  arrived  at  this  conclusion. 


The  Nature  of  Hypnosis  207 

The  first  observation  which  led  my  thoughts  in 
this  direction,  I  made  more  than  eight  years  ago. 
I  had  been  called  to  a  country  estate,  where  a  seven- 
teen year  old  boy  had  for  some  years  suffered  from 
headache,  on  account  of  which  he  had  been  obliged 
to  break  off  his  studies.  The  pain  was  plainly  of 
psychic  origin,  and  I  explained  this  to  him  in  all 
its  connections.  I  then  wished  to  make  a  trial  to 
treat  him  hypnotically  and  told  him  to  lie  down  upon 
a  couch.  He  looked  at  me  then  with  much  fear  ex- 
pressed in  his  face  and  asked: — "Do  you  intend  to 
hypnotize  me?"  I  replied  in  the  affirmative  and 
quieted  him.  He  then  said  with  deep  earnestness, — 
"I  put  myself  into  your  hands  with  complete  con- 
fidence, doctor."  He  lay  down  and  fell  at  once  into  a 
deep  sleep.  When  I  awoke  him  some  hours  later,  he 
said: — "It  was  so  wonderful.  When  you  laid  your 
hand  on  my  forehead,  I  had  exactly  the  same  feeling 
as  when  I  was  chloroformed  last  summer  before  an 
operation  for  appendicitis,  only  with  the  difference 
that  this  time  I  did  not  lose  consciousness."  After 
this  single  treatment  he  remained  definitely  free  from 
headaches. 

To  a  certain  degree,  hypnosis  in  this  case,  may  be 
looked  upon  as  a  reproduction  of  the  insensibility  of 
chloroform ;  that  is  to  say,  the  fear  in  the  beginning, 
(natural  before  a  dangerous  operation),  and  the  sud- 
den entrance  into  a  similar  physiological  condition. 
Hypnosis  would  thus  be  the  suggestive  release  of  a 


208      History  and  Practice  of  Psyclianalysis 

condition  rehearsed  in  another  way.  But  on  the 
other  hand  it  can  not  be  absolutely  explained  in 
this  way.  It  differed  from  the  chloroform  insensi- 
bility, partly  in  that  consciousness  was  retained, 
partly  in  that  there  resulted  an  indubitable  thera- 
peutic action.  I  consider  that  the  hypnosis  thus  be- 
came a  reflexive  relapse  into  an  earlier  state  of  the 
organism.  This  state  cannot  be  identified  with  the 
chloroform  insensibility,  but  must  be  sought  else- 
where; the  chloroform  insensibility  had  simply  the 
importance  of  having  acted  as  a  preparation  for  this 
relapse. 

I  have  often  observed  something  similar  to  this. 
With  experiences  of  this  kind  the  importance  of  the 
staging  of  the  forms  of  sleep  may  be  connected. 
Especially  instructive  in  this  regard  is  the  treatment 
of  alcoholists  and  morphinists.  Generally  these  are 
easily  approached  through  hypnosis.  In  order  to  ex- 
plain this  fact  the  "dissociation  of  the  nervous  sys- 
tem" is  spoken  of,  but  just  what  the  meaning  of  this 
phrase  is,  is  not  pointed  out.  It  seems  to  me  that 
the  matter  ought  rather  to  be  understood  as  a  reflex 
reproduction  of  the  intoxication,  in  the  same  way  as 
in  the  chloroform  insensibility.  Patients  who  have  the 
morphine-drowsiness  fresh  in  mind,  say  almost  as  in 
accord  to  some  rule,  after  the  first  hypnotic  treat- 
ment: "It  was  exactly  as  if  I  had  had  morphine!" 
One  patient  of  mine,  an  alcoholist,  looked  delighted 
and  exclaimed: — "That  was  just  as  good  as  a  genu- 


The  Nature  of  Hypnosis  209 

ine  spree!'*  Here  may  also  be  found  the  cause  for 
the  peculiar  fact  that  desire  for  alcohol  often  dis- 
appears after  the  very  first  hypnosis.  The  patient 
no  longer  needs  the  external  means  for  producing 
intoxication;  it  comes  through  reflex  action.  The 
further  treatment  is  then  based  upon  the  fact  that 
the  weaning  from  hypnosis  is  easier  than  is  the  wean- 
ing from  the  alcohol  habit.  But  as  little  as  with  the 
chloroform  insensibility,  must  hypnosis  be  identified 
with  the  morphine-  or  alcohol-intoxication.  The 
woman  who  gave  me  the  description  of  her  sensations 
while  under  hypnotic  treatment,  which  I  have  made 
use  of  in  this  paper,  felt  at  first  a  similarity  between 
hypnosis  and  the  morphinisms  condition ;  but  no  one 
could  possibly  confound  this  description  with  a  de- 
scription of  the  morphine-intoxication.  Considered 
aside  from  this,  hypnosis  has  a  therapeutic  action 
of  quite  another  sort  than  has  morphine.  We  must 
also  in  such  cases  allow  for  the  fact  that  the  poisons 
have  acted  as  a  kind  of  preparation  of  the  way.  But 
hypnosis  succeeds  just  as  well  with  people  who  have 
never  experienced  such  action  from  drugs ;  that  is  to 
say  the  return  to  some  condition  earlier  experi- 
enced, may  occur  without  any  such  kind  of  prepara- 
tion. 

When  it  now  becomes  a  question  of  finding  out 
when  and  how  this  condition,  which  during  the  state 
of  hypnosis  takes  the  upper  hand,  is  worked  into  the 
organism,  there  is  one  fact  which  at  once  forces  itself 


210      History  and  Practice  of  Psychanalysis 

forward.  It  has  been  agreed  upon  by  all  investiga- 
tors that  the  possibility  of  entering  the  hypnotic 
state  diminishes  with  years.  That  is  to  say,  that 
with  each  year  the  individual  gets  farther  away  from 
this  possibility.  It  is  then  necessary  to  take  only 
one  step  more  to  arrive  at  the  following: — hypnosis 
is  a  temporary  sinking  back  into  that  primary  state 
of  rest  which  obtained  during  fetal  life. 

I  also  constitute  the  thing  as  follows : — birth  is  a 
violent  revolution  through  which  the  hitherto  har- 
monious existence  is  rent  asunder.  The  human  be- 
ing comes  into  touch  with  the  external  world,  and 
in  connection  therewith  develops  a  new  state  of 
the  organism  which  we  call  the  waking  life.  This 
condition  must  be  balanced  by  another  also  new 
condition;  so  sleep  comes.  The  two  conditions  are 
contradictions  which  can  be  understood  only  in  and 
through  each  other.  Looked  at  psychologically  we 
must  suppose  a  fetal  consciousness,  even  if  this  is 
so  far  removed  from  us,  that  we  do  not  see  any 
analogy  at  all  through  which  we  can  comprehend 
it.  It  is  as  impossible  for  us  to  imagine  a  life  with- 
out consciousness  as  to  imagine  an  object  which 
occupies  no  place  in  space.  Through  the  division 
of  existence  at  birth,  a  development  of  the  conscious- 
ness arises  in  two  directions : — the  one  has  as  its 
goal  oar  wide-awake  relation  with  the  world,  the 
other  our  dream  world.  Physiologically  the  organ- 
ism adjusts  itself  to  these  new  demands.  The  ele- 


The  Nature  of  Hypnosis  211 

ment  of  destruction  which  the  waking  life  carries 
with  it,  makes  it  necessary  that  the  organism  even 
more  strongly  than  before,  may  be  able  to  concen- 
trate itself  upon  the  inner  reconstruction, — as  this 
occurs  during  sleep. 

But  at  the  time  of  such  splitting  up  of  the  primal 
state  of  rest,  a  trace  of  it  still  is  left  in  the  organism. 
We  here  find  a  circumstance  that  recurs  with  the 
constructing  of  all  new  organs  and  functions.  If 
there  is  no  effort  toward  supporting  this  trace,  it  is 
soon  covered  up  during  the  progress  of  life,  and  the 
primal  rest-state  can  no  longer  be  brought  into  func- 
tion. How  it  again  is  brought  into  the  life  through 
hypnotic  treatment,  is  connected  with  methods  and 
leads  to  questions  which  I  cannot  here  discuss. 

If,  proceeding  from  this  opinion  concerning  the 
matter,  the  five  characteristics  of  the  hypnotic  state 
which  I  have  pointed  out  are  called  to  mind,  it  is 
easy  to  understand  the  idea  without  further  explana- 
tion. 

1.  If  we  reckon  only  with  consciousness  after 
birth,  it  is  quite  true  that  an  existence  is  unrecog- 
nized by  the  psychologist,  where  this  state  of  primal- 
rest  is  still  preserved  although  detached  things  dis- 
appear out  of  it.  In  order  to  understand  the  fact 
that  such  a  condition  shows  itself  during  hypnosis, 
it  is  necessary  to  go  back  to  the  existence  prior  to 
birth.  No  matter  how  little  we  may  know  con- 
cerning consciousness  as  existing  in  that  state,  so 


History  and  Practice  of  Psychanalysis 

much  may  be  quite  certain, — that  it  is  not  occupied 
with  a  single  thing  belonging  to  the  outside  world. 
So  considered  it  may  not  be  too  bold  to  presume  that 
all  the  Nirvana  fantasies  are  added  to  this  trace  of 
memory. 

2.  Concentration  in  itself  takes  the  thought  to  a 
time  when  that  division,  which  the  relation  with  the 
world  carries  with  it,  had  not  yet  arisen.    The  isola- 
tion is  a  reproduction  of  that  form  in  which  we  lived 
when  we  were,  as  yet,  unattached  by  any  bond  to 
the  external  world. 

3.  To  understand  the  physiological  condition,  it 
must  be  pointed  out,  that  the  mental  functions  first 
begin  to  act  when  the  skin  starts  to  play  its  part 
in  fixing  boundaries  against  the  outer  world.    What 
is  so  characteristic  in  hypnosis, — the  withdrawal  of 
energy  from  the  surface  of  the  body,  is  thus  noth- 
ing but  a  regression  to  the  state  during  an  epoch 
when  this  had,  as  yet,  not  been  projected, — when 
the  surface  of  the  body  as  such  did  not  yet  exist. 
Catalepsy  is,  in  the  same  way,  a  regression  to  the 
fetal  form  of  muscular  function.     That  which  seems 
to  me  to  stand  out  most  clearly  about  the  cataleptic 
state  is  not  the  fact  that  the  extremities  remain  in 
whatever  uncomfortable  position  in  which  they  may 
be  placed,  but  that  this  phenomenon  occurs  without 
any  feeling  of  weariness.    It  seems  to  be  explainable 
only  as  a  regression  to  a  state,  in  which  the  feeling 
of  weariness   had   not   yet   arisen, — in   which   thus 


The  Nature  of  Hypnosis  313 

remaining  in  a  very  uncomfortable  attitude  was  nat- 
ural. The  disappearance  of  pain  and  other  phe- 
nomena during  hypnosis,  becomes  also  in  this  way 
understandable;  they  doubtless  originate  from 
functions  which  may  not  have  been  in  activity  dur- 
ing the  fetal  life. 

The  feeling  of  pressure  is  a  re-experiencing  of  the 
intra-uterine  pressure.  The  question  should  be  raised 
as  to  whether  no  other  traces  of  memory  from  fetal 
life  may  be  pointed  out  during  hypnosis.  A  male 
patient  said  to  me  after  the  first  seance,  that  dur- 
ing the  whole  time  he  had  had  a  sensation  as  if 
his  body  swayed  back  and  forth  as  in  a  swing.  A 
young  woman  complained,  after  a  prolonged  sleep, 
that  the  ground  swayed  under  her.  When  I  paid 
closer  attention  to  this,  it  appeared  that  she  had 
already  had  a  feeling  that  the  bed  was  swaying 
under  her  in  the  same  way,  during  the  first  treat- 
ment I  gave  her.  I  reproved  her  for  not  telling  me 
this  at  once,  so  that  I  might  have  had  an  opportun- 
ity to  suggest  the  idea  away.  She  answered  that  she 
had  believed  this  sensation  to  be  necessarily  con- 
nected with  hypnosis.  That  there  is  not  more  fre- 
quent opportunity  to  observe  such  sensations,  very 
likely  has  its  reason  in  the  fact  that  the  hypnotist 
immediately  tries  to  suppress  all  attempts  in  that 
direction  by  means  of  counter  suggestions. 

4.  The  prominence  of  automatism  in  hypnosis 
indicates  the  return  to  a  form  of  life  when  the  in- 


History  and  Practice  of  Psychanalyna 

dividual  was  nothing  but  an  automatically  regulated 
vegetative  organ  within  the  mother. 

5.  If  this  opinion  is  correct  it  is  easily  understood 
how  hypnosis  is  able  to  bring  about  a  state  of  rest, 
with  which  no  other  kind  of  rest  can  be  compared. 
Patients  often  say  after  an  hour's  hypnotic  sleep, 
that  they  feel  more  refreshed  than  after  sleeping  the 
whole  night.  Only  in  one  way  is  the  detachment 
from  everything  which  keeps  a  tension  upon  us  pos- 
sible, namely  through  a  sinking  back  into  a  condi- 
tion when  this  tension  had  not  yet  begun  to  exist. 

It  ought  now  through  experiment  to  be  easy  to 
find  confirmation  of  this  opinion  regarding  the  na- 
ture of  hypnosis.  Unfortunately  I  have  not  had 
opportunity  to  do  this ;  I  have  been  obliged  to  satisfy 
myself  with  whatever  observations  I  could  make  in 
my  practice. 

I  should  like  however  to  give  an  idea  of  one  way 
of  going  about  such  experimentation.  People  who 
have  undergone  psychanalysis,  describe  many  differ- 
ent dream  situations  which  they  carry  back  to  the 
fetal  memory-trace.  One  should  be  able  to  investi- 
gate how  numerous  such  cases  are;  if  hypnotism  is 
crossed  with  sleep  and  if  dream-pictures  present 
themselves  when  the  content  of  the  waking  conscious- 
ness disappears.  In  actual  practice  it  is  always 
necessary  to  direct  the  consciousness  towards  a  de- 
cided goal;  consequently  one  has  in  practice  no 
opportunity  to  make  such  observations.  But  In  this 


The  Nature  of  Hypnosis 

connection  I  wish  to  call  to  mind  a  circumstance 
belonging  to  the  time  prior  to  the  discovery  of  sug- 
gestion, when  the  sleeping  patient  was  left  to  him- 
self with  whatever  fancies  arose  in  his  mind.  It  was 
found  then,  that  the  world  of  imagination  was  gen- 
erally ruled  by  one  single  theme,  namely  the  internal 
organs  of  the  body.  On  account  of  this  arose  the 
teaching  concerning  clairvoyance: — people  believed 
that  the  medium  was  able  to  actually  see  the  work- 
ings of  the  various  organs.  It  seems  to  me  that  the 
matter  ought  to  be  explained  thus :  that  during  sleep 
the  deeply  buried  sensations  from  the  fetal  period, 
again  come  to  life  and  then  with  the  assistance  of 
later  acquired  idea-material,  construct  out  of  them- 
selves all  those  descriptions  which  fill  the  literature 
of  animal-magnetism. 

Finally  I  want  to  point  out  the  practical  conclu- 
sion of  my  opinion  regarding  the  nature  of  hypnosis. 
In  the  course  of  the  years  during  which  this  opinion 
was  becoming  constantly  more  clear  to  me,  I  ac- 
quired a  surer  foundation  for  hypnotic-therapy.  If 
the  opinion  proves  itself  true  it  will  also  become 
more  clearly  possible  to  judge  than  it  hitherto  has 
been,  in  which  cases  treatment  by  hypnosis  is  in- 
dicated; it  will  no  longer  be  necessary  as  hereto- 
fore, to  fumble  about  in  the  maze  of  possibilities 
and  to  experience  disappointments  in  practice. 

Even  more  important  does  it  seem  to  me  to  be 
that  a  sure  way  of  producing  hypnosis  can  be  found 


216     History  and  Practice  of  Psychanalysis 

in  all  those  cases  in  which  its  use  is  desirable.  For 
all  who  are  engaged  in  making  use  of  hypnotism 
as  a  method  of  treatment  it  may  then  be  a  certainty, 
that  the  neurotic  who  is  reachable  through  hypnosis, 
has  in  it  a  powerful  weapon  against  illness;  we 
have  all  probably  had  the  bitter  experience  of  finding 
that  our  most  earnest  effort  to  produce  hypnosis 
has,  sometimes,  been  unsuccessful  and  this  may  be 
the  chief  reason  why  this  mode  of  treatment  does  not 
develop  more  rapidly. 

Here  then,  the  problem  is  changed.  Instead  of 
asking  how  shall  hypnosis  be  induced  the  question 
is:  how  may  the  state  of  primal-rest  be  prevented 
from  disappearing  so  entirely,  that  it  no  longer  can 
be  actualized?  The  practical  answer  to  this  ques- 
tion is  very  simple.  Almost  without  exception  the 
attempt  to  hypnotize  a  child  succeeds,  and  if  hyp- 
notism has  been  practiced  upon  the  child,  it  may  in 
the  majority  of  cases  be  brought  into  activity  during 
riper  years. 

Neurosis  is,  as  psychanalysis  undoubtedly  shows, 
no  single  limited  happening  in  the  life  of  the  adult ; 
it  is  rather  to  be  considered  as  a  colored  thread 
which  starting  in  childhood  runs  on  through  life  and 
twines  itself  around  life's  varied  experiences  in  every 
direction,  trying  to  bring  existence  into  a  state  of 
confusion.  In  consequence  one  ought,  through  close 
observation,  to  be  able  to  make  the  diagnosis  dur- 


The  Nature  of  Hypnosis  217 

ing  childhood.  If  the  first  symptoms  then  can  not 
be  overcome,  at  least  the  child  should  be  given  the 
weapon  which  hypnosis  provides,  to  help  towards 
overcoming  the  threatening  enemy. 


VI 

THE  CONSCIOUS  VERSUS  THE  UNCONSCIOUS 

I  WAS  once  spending  a  few  days  in  a  foreign 
town,  when  a  woman  called  upon  me  to  get  my 
opinion  regarding  her  case.  In  appearance  she  was 
delicately  built,  and  impressed  me  as  one  who  had 
suffered  much.  She  gave  me  the  following  history : — 
At  the  age  of  twenty-four  she  had  made  a  love- 
match.  She  was  now  in  her  early  forties.  Her  hus- 
band was  a  professor  and  had  always  entertained 
the  warmest  affection  for  her.  She  was  able  to  say 
that,  up  to  the  time  of  her  present  illness,  her  mar- 
ried life  had  been  an  unusually  happy  one.  She 
had  had  four  children  who  were  all  in  good  health 
and  well  developed.  Her  way  of  life  was  frugal  but 
it  was  without  financial  worries.  Her  last  child  had 
been  born  ten  years  prior  to  the  time  of  her  con- 
sultation with  me,  and  it  was  from  that  occurrence 
she  dated  the  beginning  of  her  present  condition. 
The  delivery  of  this  child  had  been  a  very  severe 
ordeal  and  had  been  followed  by  puerperal  fever. 
She  had  been  confined  for  many  weeks  to  her  bed, 
lingering  between  life  and  death,  and  her  vitality 

218 


The  Conscious  Venus  the  Unconscious     £19 

had  been  very  greatly  depleted.  She  had  since  al- 
ways imagined  that  this  exhaustion  had  been  the 
cause  of  the  condition  which  followed.  The  con- 
nection between  cause  and  effect  had,  however,  re- 
mained a  secret  over  which  she  had,  during  all  these 
years,  daily  brooded. 

During  the  attack  of  puerperal  fever  she  had 
been  treated  most  skillfully  by  an  elderly  physician. 
Some  times  he  had  made  his  call  in  the  evening, 
staying  for  a  time  in  the  twilight,  merely  sitting 
quietly  beside  her  bed.  She  noticed  how  after  a 
time,  he  gradually  occupied  more  and  more  of  her 
thoughts,  so  that  she  began  to  long  for  his  visits  and 
found  the  time  he  spent  with  her,  the  only  time  of 
the  whole  day  when  she  really  felt  any  pleasure  in 
life.  She  guarded  every  word  he  spoke  to  her  and 
began  finally  to  talk  with  him  in  her  thoughts. 

The  feeling  she  entertained  regarding  the  matter 
became  something  almost  sacred  to  her,  something 
for  which  she  certainly,  at  that  time,  had  no  fear. 
She  believed  that  it  arose  only  from  her  illness  and 
because  of  the  fact  that  the  doctor  had  a  quieting 
influence  upon  her.  She  was  sure  that  in  her  inner 
life  she  would  return  to  her  usual  condition,  as  soon 
as  the  illness  no  longer  separated  her  from  the  nor- 
mal external  state  of  affairs.  But  after  her  re- 
covery it  quickly  became  clear  to  her  that  the  doctor 
had  made  so  deep  an  impression  upon  her  mind,  that 
she  was  unable  to  make  herself  free  from  him.  As 


220      History  and  Practice  of  Psychanalysis 

soon  as  she  awoke  in  the  morning,  she  saw  him, 
mentally,  before  her;  wondered  if  she  would,  pos- 
sibly, meet  him  during  the  day;  what  he  might  then 
be  doing;  if  he  was  thinking  about  her,  etc.  If  she 
went  out  she  thought  she  saw  him  in  every  other 
man  she  met.  If  the  telephone  rang,  she  thought, 
"That  must  be  he!"  If  she  read  something,  in  her 
thoughts  she  talked  it  over  with  him.  If  she  sat 
alone,  letting  her  thoughts  wander  where  they  would, 
one  fantasy  after  another  obtruded  itself  upon  her 
and  everything  was  connected  with  him.  Shortly,  in 
every  minute  of  the  day,  in  everything  she  attempted 
to  do,  he  was  not  only  present,  but  was  even  the 
central  point  about  which  all  else  revolved. 

These  experiences  were  very  strange  to  her  and 
all  her  pleasure  in  life  little  by  little  was  destroyed 
by  this  hopeless  brooding.  She  was  obliged  over  and 
over  again  to  ask  herself,  if  she  did  in  truth  be- 
long to  this  man  and  what  would  happen  if  he 
should  say  to  her:  "Come  to  me."  Sometimes  she 
felt  herself  so  entirely  a  paitt  of  him  that  she 
thought  she  would  be  able  to  give  up  everything  else 
for  his  sake.  But  at  the  same  time  she  could  not 
believe  that  all  her  married  life  had  been  built  upon 
a  lie.  She  belonged  to  her  husband  and  her  children 
and  under  all  circumstances  would  she  remain  in  her 
home.  She  talked  the  whole  thing  over  with  her 
husband,  but  he  was  not  able  to  advise  her.  In  her 
need  she  went  to  the  doctor,  with  whom  she  now  no 


The  Conscious  Versus  the  Unconscious 

longer  met,  and  frankly  related  the  entire  story 
to  him,  hoping  that  this  might  bring  relief.  But  it 
did  not  help  matters  as  he  was  quite  as  much  at  a 
loss  as  her  husband  had  been.  She  perceived  that 
if  she  did  not  wish  to  become  wholly  a  wreck,  she 
would  have  to  put  aside  all  these  ruinous  thoughts. 
With  all  the  strength  that  was  inherent  in  the  purity 
of  her  character,  she  struggled  against  the  doctor 
as  against  an  enemy.  Every  hour  of  the  day  she 
filled  with  useful  work  and  in  the  evening  went,  ex- 
hausted, to  bed.  Only  after  some  years  of  this  was 
she  successful  in  feeling  a  sense  of  freedom  for  per- 
haps half  an  hour  or  a  little  more  during  the  day. 
In  this  way  she  had  lived  for  ten  whole  years. 

The  history  of  course  turned  my  thoughts  into  a 
definite  direction.  I  asked  her  some  questions  about 
her  childhood  and  more  about  her  married  life. 

She  had  been  brought  up  under  happy  circum- 
stances. Her  father  was  a  teacher.  Both  parents 
were  still  living.  She  had  one  brother  and  the 
parents  were  accustomed  to  say  that  he  was  his 
mother's  boy  while  she  belonged  to  her  father.  As 
a  little  child  she  has  been  often  ill  and  at  such  times 
she  had  been  treated  by  her  father  with  the  greatest 
tenderness.  She  could  still  recall  the  nights  of  fever 
when  he  had  sat  beside  her  bed.  She  had  loved  him 
with  all  the  fanciful  adoration  of  a  child.  One  detail 
directed  my  attention  to  the  great  influence  he  had 
had  upon  the  development  of  her  life.  At  her  con- 


222      History  and  Practice  of  Pgychanalysis 

firmation,  he  had  given  her  a  book  in  which  he  had 
written  some  lines.  These  words  had  burned  them- 
selves into  her  mind  and  had  become  the  guiding 
motive  of  her  whole  life. 

As  to  her  married  life,  the  fact  that  her  husband 
was  delicate  at  the  time  of  their  marriage,  played 
a  certain  role.  The  feeling  of  love  for  him  had  come 
upon  her  gradually.  A  friend  had  been  accustomed 
to  say  to  her:  "That  man  should  be  your  husband. 
You  could  make  something  of  him  and  help  him 
recover  his  health."  Undoubtedly  the  mother-feeling 
for  the  man  was  one  of  the  chief  ingredients  in  the 
emotional-complex  of  her  love  and  it  continued  so  to 
be  in  the  time  that  followed.  But  she  had  had  noth- 
ing to  regret.  With  great  satisfaction  she  had  real- 
ized how  her  husband  became  happier  and  healthier. 
She  had  herself  always  been  dearly  loved  by  him 
and  in  the  beginning  had  been  as  much  satisfied  as  a 
wife,  generally  speaking  perhaps,  can  be.  Neverthe- 
less, there  was  in  her  life  a  kind  of  emptiness  from 
which  she  was  unable  to  escape  and  which,  as  the 
years  went  by,  increased.  On  the  one  hand  she 
sometimes  felt  a  passing  erotic  emotion  towards  men 
whom  she  occasionally  met  and  whom  she  did  not  at 
all  wish  to  approach.  This  troubled  her  very  much. 
In  her  secret  thoughts  always  she  wished  to  remain 
true  to  her  husband.  She  brooded  over  the  question 
as  to  whether  there  was  some  defect  in  him,  or  if 
she  herself  were  really  a  bad  woman,  or  if  perhaps, 


The  Conscious  Versus  the  Unconscious      223 

every  woman  had  something  of  this  feeling.  On  the 
other  hand  she  was  sometimes  tortured  by  an  un- 
comfortable, undefined  longing.  It  was  hard  for  her 
to  describe  in  words,  just  in  what  this  consisted. 
She  could  express  it  best  perhaps  by  saying  that  she 
wished  that  she  might  for  once  be  loved,  not  as  a 
mother,  not  as  a  wife,  but  exclusively  for  her  own 
sake,  quite  independently  of  the  question  as  to 
whether  she  were  useful  to  her  husband  or  not. 
Some  depths  in  her  innate  womanly  nature  revolted 
against  the  married  life.  She  was  ashamed  of  it  but 
she  could  not  deny  it. 

Here  apparently  was  an  example  of  Freud's  dis- 
covery of  the  transference  of  the  father-complex  to 
the  doctor. 

The  explanation  of  this  idea  made  a  deep  impres- 
sion upon  the  patient.  On  the  one  hand  she  at  once 
got  hold  of  a  vague  idea  that  this  was  the  secret 
of  her  trouble;  on  the  other  hand  she  understood 
that  she  would  never  have  been  able  to  discover  it 
for  herself,  even  if  she  had  pondered  over  it  the 
whole  of  her  life  through. 

When  she  returned  to  me  the  following  day,  she 
was  able  to  relate  many  details  which,  in  the  inter- 
val, had  come  into  her  mind  and  which  confirmed 
my  theory.  Among  those  compulsion-fantasies 
which  had  the  doctor  as  their  central  point,  the  fol- 
lowing riddle  for  example,  came  back  again  and 
again:  she  seemed  to  be  sitting  on  a  little  footstool 


History  and  Practice  of  Psyclianalysis 

in  the  corner  of  a  room.  The  doctor  was  walking 
up  and  down  reading  a  book.  She  sat  quite  still, 
listening  to  his  footsteps  and  feeling  the  greatest 
contentment.  She  recognized  here  the  newly-con- 
structed impression  of  a  recollection  from  childhood. 
Just  like  this  she  had  been  accustomed  to  sit  upon 
a  footstool  in  a  corner  of  her  father's  study  and  he 
had  had  the  habit  of  walking  in  this  way,  up  and 
down  as  he  read.  She  had  often,  too,  pondered  over 
the  following  detail :  When  in  imagination  she  again 
lived  through  the  visit  of  the  doctor,  she  recalled 
how  he  never  rang  as  other  visitors  did;  he  opened 
the  door  for  himself  and  she  heard  his  steps  at  once 
outside  in  the  entrance  hall.  Just  in  this  way  had 
she  always  heard  her  father  when  he  came  home. 
Shortly  one  problem  after  another  found  its  natural 
solution. 


There  is  nothing  novel  in  this  history.  I  have  se- 
lected it  because  of  its  unusual  simplicity  and 
because  to  me  it  seems  rather  well  adapted  for  throw- 
ing light  upon  a  question  which  in  my  opinion  in- 
volves the  cardinal  point  in  psychanalytical-therapy. 
In  this  case  we  confront  a  division  of  the  personality 
into  two  parts  between  which  the  patient  wavers, 
unable  to  find  rest  in  either  direction.  One  part  con- 
sists of  the  past  life,  the  childhood,  condensed  in  the 


The  Conscious  Versus  the  Unconscious     225 

figure  of  the  father;  the  other  consists  of  the  pres- 
ent which  has  its  center  in  the  married  life  and  in 
everything  connected  with  that.  It  may  also  be  said 
that  one  part  consists  of  the  repressed  portion  of  the 
life,  that  is  to  say,  of  the  unconscious;  the  other  of 
the  conscious.  The  neurosis  arose  because  the  or- 
ganization of  these  two  worlds  which  had  been  built 
up  in  the  course  of  the  patient's  life,  was  broken  up 
so  that  in  her  actual  life  two  opposing  complexes, 
which  under  normal  circumstances  must  have  ex- 
cluded each  other,  began  to  struggle  against  each 
other.  It  resulted  in  the  situation: — the  conscious 
versus  the  unconscious.  Something  akin  to  this  is  to 
be  found  in  every  form  of  neurosis.  What  is  to  be 
said  concerning  this  case  may  therefore  easily  be 
applicable  to  every  case. 

At  the  point  in  the  description  of  the  case  where 
I  broke  off,  the  unconscious  confusion  lay  broadly 
before  me.  But  by  means  of  such  an  explanation 
the  patient  is  not  helped.  Notwithstanding  the  fact 
that  the  intellect  can  grasp  the  condition  of  com- 
pulsion, the  patient  remains  as  unhappy  as  before. 
The  question  must  present  itself :  "What  shall  I  now 
do?  In  what  way  can  this  new  knowledge  aid  me?" 
And  subsequently  the  analyst  must  ask  himself: 
"How  shall  I  proceed  with  this  treatment?" 

The  question  has  become  a  very  real  ottie  in 
psychanalysis.  It  is,  e.  g.,  to  be  found  in  the  last 
number  (1913,  No.  IV)  "Die  Zietschrift  fur 


226      History  and  Practice  of  Psychanalyria 

artzliche  Psychoanalyse,"   in   Ferenczi's   article  on 
Jung's  "Wandlungen  und  Symbole  der  Libido."   He 


He  (Jung)  considers  the  most  important  factor 
in  the  treatment  of  nervous  patients  to  be  the  guiding 
back  to  the  road  of  reality,  from  which  they  have 
been  turned  aside.  But  we  still  maintain  that  the 
closest  and  most  important  realities  for  the  patient 
are  the  symptoms  of  his  illness,  and  that  because  of 
this  we  should  be  concerned  only  with  these.  When 
one  directs  the  attention  of  the  patient  upon  his  life- 
work  it  results  only  in  making  him  suffer  the  more, 
because  of  his  inability  to  perform  that  work.  The 
life-plan  of  the  patient  ought  not  to  be  taken  into 
consideration  in  making  the  analysis ;  if  it  is  carried 
deeply  enough  the  patient  finds  a  way  out  of  his 
difficulty  for  himself,  without  assistance.  The  prop- 
er analytical  technique  must  try  to  make  the  patient 
so  independent  of  the  analyst  that  he  will  no  longer 
care  for  his  advice. 

According  to  Ferenczi  therefore  the  matter  should 
be  treated  in  the  following  manner: — one  should  be- 
gin in  the  usual  way  and  through  free  associations 
bring  still  more  material  out  of  the  unconscious. 
This  should  be  done  without  any  tendency  on  the 
part  of  the  analyst;  that  is  to  say,  the  analyst 
should  work  in  the  same  manner  as  a  chemist  who 
decomposes  some  substance  into  its  elements.  Prac- 
tically, in  the  case  under  consideration  the  method 
would  be  as  follows:  we  should  here  break  up  the 


The  Conscious  Versus  the  Unconscious     227 

whole  related  history  into  its  separate  parts  as  a 
dream  is  broken  up,  with  its  separate  dream-pic- 
tures, and  investigate  each  and  every  one  of  these 
parts  to  discover  what  is  hidden  therein.  We 
should  examine  every  passing  erotic-inclination  and 
bring  every  possible  thing  to  light  in  all  that  has 
connection  with  it.  Every  memory  from  childhood, 
every  experience  of  the  married-life  should  be  treated 
in  the  same  way  and  after  this  the  patient  should 
be  dismissed. 

The  first  question  which  now  arises  is  this: — 
Can  analysis  ever  be  made  so  entirely  free  from  the 
assumption  of  something,  as  it  should  be,  if  a  prin- 
ciple like  this  is  followed? 

Opponents  of  psychanalysis  often  assert  that  the 
analyst  always  knows  just  what  the  end  of  the 
analysis  will  be  as  soon  as  the  beginning  of  it  is 
known.  I  will  not  say  if  there  is  any  truth  in  that 
opinion  or  not.  But  I  believe  that  it  is  not  pos- 
sible to  remain  entirely  free  from  assumptions.  Un- 
less the  analyst  makes  the  case  clear  for  himself  and 
if  during  the  treatment  he  is  not  led  by  a  general 
opinion  of  the  individual  situation,  there  is  danger 
always  of  being  guided  by  an  assumed  theory.  No 
one  can  assert  any  injustice  towards  psychanalysts 
on  my  behalf,  if  I  say  that  I  believe  that  there  are 
those  who  in  the  case  cited,  would  eventually  have 
arrived  at  the  incest-complex.  They  would  have  so 
tonducted  the  analysis  that,  through  free  associa- 


228     History  and  Practice  of  Psyclianalysis 

tions,  they  might  bring  into  light  the  idea  that  all 
the  erotic  inclinations  were  substitutes  for  the  father 
and  that  the  experiences  of  the  married-life  were  car- 
ried over  from  childhood  memories.  The  prevailing 
theory  is  so  firmly  fixed  in  many  heads,  that  it  over- 
rules all  other  directing  motives.  We  must  all  agree 
that  life  cannot  be  compressed  into  any  one  theory, 
even  if  this  has  its  origin  in  the  highest  genius  and 
appears  to  be  all-embracing. 

In  working  out  the  analysis  of  a  life  in  its  vary- 
ing fluctuations,  one  ought  never  to  begin  from  a 
point  external  to  the  individual;  the  point  from 
which  the  analysis  is  begun,  must  be  sought  for  with- 
in the  individual.  In  reading  reports  of  the  ordinary 
analyses  it  is  difficult  not  to  wonder  if  the  resistance 
of  the  patient  is  not  a  resistance  against  the  theory 
of  the  analyst  rather  than  against  the  truth.  If  an 
individual  opposes  himself  against  truth  it  is  un- 
natural and  must  be  overcome,  but  if  he  opposes 
himself  against  the  fixing  of  his  mind  into  a  strange 
theory,  then  it  is  the  result  of  the  instinctive  feeling 
of  self-preservation,  and  this  should  be  respected. 

But  if  I  take  the  position  that  analysis  can  be 
carried  out  without  theoretical  assumptions,  the 
question  arises,  what  is  the  therapeutic  value  of  per- 
mitting the  unconscious  material  of  life  to  inundate 
the  consciousness  in  this  way. 

It  is  possible  to  argue  the  question  after  which 
principle  the  unconscious  material  of  life  is  ar- 


The  Conscious  Versus  the  Unconscious     229 

ranged,  that  is  to  say  if  it  is  entirely  subordinated 
to  the  lust-principle  or  not.  One  thing  may  be  sure, 
viz :  it  is  not  arranged  after  any  principle  that  means 
an  absolute  adaptation  to  life.  I  mean,  when  it  is 
made  apparent  to  the  consciousness,  it  does  not 
automatically  arrange  itself  so  that  the  patient  im- 
mediately finds  his  way  back  to  life.  To  believe 
something  like  that,  would  be  to  make  of  the  uncon- 
scious a  god.  In  comparison  with  the  consciousness, 
the  unconscious  contains  something  of  chaos.  Now 
the  neurosis  consists  in  the  fact  that  the  patient 
has  not  been  able  to  discover  a  way  out  of  that  part 
of  life  which  he,  hitherto,  has  known.  How  then 
would  he  find  his  way  out  of  the  new  chaos?  Imagine 
for  instance  the  patient  in  the  case  here  cited. 
Hitherto  she  had  lived  in  a  kind  of  hell  because  she 
did  not  know  whether  her  life  was  bound  up  with 
that  of  the  doctor  or  with  that  of  her  husband.  Now 
in  addition,  she  must  ponder  the  question  whether 
she  may  not  in  the  same  way  be  bound  up  with  any 
of  those  other  men  for  whom  she  had  had  a  fleeting 
erotic  inclination.  So  would  she  become  entangled  in 
a  thousand  new  problems. 

What  Ferenczi  says  concerning  the  purpose  of 
making  the  patient  independent  of  the  analyst  is 
quite  justifiable.  But  the  patient  never  becomes  so 
before  he  has  acquired  a  genuine  connection  with  life. 
The  leaving  of  a  patient  in  a  condition  wherein  he 
finds  his  life  becoming  only  a  much  more  difficult 


230      History  and  Practice  of  Psychanalysis 

problem  to  solve,  means  that  he  must  either  remain 
a  neurotic  or  else  seek  help  in  some  other  direc- 
tion. 

To  me  it  seems  that  this  fundamental  principle  of 
psychanalysis  is  the  remnant  of  its  first  epoch.  At 
that  time  there  was  belief  in  a  solution  by  way  of 
intellectuality;  if  repressed  wishes  only  could  come 
into  the  consciousness,  everything  would  regulate 
itself.  That  opinion  has  of  course  been  changed. 
But  analysis  is  nevertheless  made  use  of  in  a  way 
that  makes  it  appear  that  the  opinion  is  still  ten- 
able. 

This  epoch  brought  us  much  new  information  con- 
cerning the  unconscious  life,  and  there  can  be  no 
doubt  that  further  work  along  these  lines  will  show 
still  richer  results.  But  that  is  a  scientific  matter 
which  only  indirectly  has  a  therapeutic  value.  I 
believe  that  a  clearer  standpoint  upon  these  ques- 
tions can  only  be  reached  when  we  separate  science 
more  decidedly  than  is  generally  done,  from  the  art 
of  healing.  Here  we  have  something  analogous  to 
that  which  occurred  in  the  first  days  of  the  hypnotic 
era.  Nobody  is  likely  to  try  to  refute  the  great 
scientific  value  of  Charcot's  explanation  of  hysteria. 
That  the  experiments  he  made  had  any  therapeutic 
worth  he  did  not  himself  pretend.  To  me,  it  seems 
that  the  violent  attacks  against  psychanalysis  some- 
times have  root  in  the  fact  that  something  is  claimed 
for  therapeutics,  which  really  has  only  scientific 


The  Conscious  Versus  the  Unconscious     281 

value.  Therapeutics  is  more  decidedly  an  art  in  it- 
self and  must  not  be  subordinated  to  science. 

I  am  therefore  unable  to  agree  with  Ferenczi  con- 
cerning the  matter  of  the  continuation  of  the  treat- 
ment in  the  case  cited.  I  rather  here,  ally  myself  to 
Jung's  opinion : — the  task  of  the  physician  is  to  show 
the  patient  the  way  to  reality ;  and  in  order  to  avoid 
misconceptions  I  should  like  to  point  out  what  I 
mean  by  the  word  "reality."  In  introducing  into 
empirical  research  an  idea  which  has  been  mishandled 
by  metaphysical  philosophy,  there  is  easily  danger  of 
introducing  something  of  speculation  which  is  out 
of  place  there.  In  looking  at  anything  from  the 
empirical  point  of  view  we  are  living  in  a  world  of 
relative  conditions;  an  absolute  reality  never  comes 
into  question.  It  is  only  an  adaptation  of  one's  self 
to  the  external  part  of  existing  relative  conditions 
and  that  adaptation  must  be  looked  upon  as  the 
best  possible  one,  which,  in  the  highest  degree  de- 
velops pleasure,  the  making  free  of  forces,  power 
over  one's  life,  in  short  everything  that  for  us 
means  the  affirmation  of  life  itself.  Instead  of  seek- 
ing after  absolute  reality,  that  which  has  the  highest 
reality  value  should  be  sought. 

According  to  Jung  it  is  not  enough  that  the  ma- 
terial of  the  unconscious  life  be  brought  to  light. 
It  is  necessary  that  the  patient  be  taught  to  attain 
power  over  it,  to  apprehend  the  difference  between 
actuality  and  illusion.  An  understanding  must  be 


232      History  and  Practice  of  Psydianalysis 

accorded  him,  as  to  where  the  different  ways  be- 
tween which  he  has  to  choose,  will  lead,  etc.  Psych- 
analysis  here  ceases  to  be  something  for  itself  alone 
and  becomes  subordinated  to  a  principle  which  may 
be  considered  the  chief  principle  of  psychotherapy. 
Here  is  a  bridge  which  joins  psychanalysis  to  other 
psychotherapeutic  endeavors.  The  analysis  must 
be  gone  through  with  because  the  road  to  reality  is 
blocked  by  unconscious  complexes,  because  the  pa- 
tient is  driven  away  from  that  road  by  unconscious 
forces,  not  because  the  analysis  in  itself  has  any 
healing  value. 

But  in  replying  to  the  question  as  to  the  continua- 
tion of  the  treatment  in  this  way,  the  answer  is  by 
no  means  made  clear.  We  have  arrived  only  at 
that  place  where  we  stand  before  the  real  cardinal 
point  of  psychanalytical-therapy.  This  may  be  for- 
mulated as  follows : — ought  the  highest  reality  value 
to  be  placed  upon  the  unconscious  or  upon  the  con- 
scious life?  I  said  before  that  that  point  should 
be  sought  within  the  patient,  from  which  life  shall 
be  made  clear  to  him ;  in  this  search  then,  ought  the 
central  point  of  the  conscious  or  that  of  the  uncon- 
scious mind  be  chosen? 

This  question  must  have  a  decided  answer,  if,  as 
in  the  case  cited  in  this  paper,  the  unconscious  mind 
is  in  such  a  struggle  with  the  conscious,  that  no 
accommodation  is  possible, — that  either  the  one  or 
the  other  must  become  subordinated.  Briefly,  the 


The  Conscious  Versus  the  Unconscious     233 

question  must  be  decided  as  to  whether  the  father- 
complex  or  the  later  years  are  to  be  declared  the 
factor  which  played  the  part  of  reality  in  the  pa- 
tient's life;  upon  this  decision  hangs  the  following 
interpretation  of  the  case. 

If  the  first  possibility  is  chosen,  the  patient  would 
be  addressed  something  like  this :  "You  have  idolized 
your  father  and  he  has  dominated  the  whole  de- 
velopment of  your  life.  Have  you  really  ever  be- 
come free  from  him?  I  can  scarcely  believe  so. 
What  was  it  that  held  you  back  at  the  time  when 
first  you  met  the  man  who  afterwards  became  your 
husband?  It  was  that  bond  which  attached  you  to 
your  father.  To  sacrifice  him  would  have  meant  to 
sacrifice  so  much  of  yourself  that  never  again  could 
you  have  found  happiness  in  life.  The  feeling  you 
have  for  your  father  you  call  love,  and  doubtless 
you  have  regarded  it  as  something  ideal.  If  you 
examine  it  more  clearly  you  will  discover  that  this 
feeling  was  not  entirely  free  from  sensuality.  It  was 
a  sensual  pleasure  to  you  when  he  cared  for  you.  If 
you  recall  the  sensations  with  which  you  were  filled 
when  he  touched  you, — caressed  you, — dressed  you, 
— put  you  to  bed,  you  will  find  that  the  body  played 
a  great  part  in  all  this.  That  you  have  never  been 
free  in  your  sexual-life  is  evident  from  the  passing 
erotic  inclinations  you  have  described.  You  have 
always  longed  in  vain  for  something.  This  inability 
to  become  free  has  its  root  in  the  fact  that  your 


234      History  and  Practice  of  Psychanalysis 

sexual  impulses  have  been  bound  up  in  your  father. 
Neither  in  the  ideal  love  nor  in  the  sensual  love 
have  you  succeeded  in  breaking  loose  from  him.  All 
that  which  you  have  lived  in  the  past  has  been  a  sub- 
stitute for  him.  Especially  has  the  love  for  your 
husband  been  such  a  substitute.  For  a  certain  num- 
ber of  years  you  succeeded  in  maintaining  the  illu- 
sion of  freedom  in  the  married  life.  But  nature  can- 
not be  driven  away.  When  you  became  ill  and  so 
no  longer  had  the  power  to  keep  nature  from  you 
by  means  of  self-suggestions  of  happiness,  the  father 
once  more  laid  claim  to  that  which  already  was  his. 
This  time  he  came  to  you  embodied  in  the  doctor. 
Upon  this  doctor  you  were  able  to  transfer  in  high- 
est degree,  the  love  for  your  father;  in  speaking 
of  love  in  connection  with  your  life,  it  would  mean 
this  feeling  to  which  we  must  refer.  Your  father 
is  the  substituted  picture.  Had  you  been  able  to 
follow  this  feeling  you  could  also  have  experienced 
a  much  stronger  sexual  freedom  when  in  the  married 
life,"  etc. 

It  must,  however,  be  made  clear  that  if  the  patient 
had  been  shown  this  way  to  reality,  in  the  further 
analysis  one  would  expect  to  find  more  testimony  for 
the  supposition  that  this  way  was  the  right  one. 
The  unconscious  mechanism  is  thus  fixed  upon  as 
the  reality  and  everything  that  is  brought  to  light 
appears  as  a  ratification  of  it.  If  this  way  is  false 
it  may  never  be  amenable  to  correction ;  the  patient 


The  Conscious  Venus  the  Unconscious     235 

will  be  driven  still  farther  on  the  already  chosen 
path.  Resistances  which  try  to  block  the  path  will 
be  regarded  as  resistances  which  must  be  overcome. 
The  patient  struggles  against  a  change  of  the  values 
in  life,  which  seem  doubtful  to  him.  This  struggle 
is  really  just  as  definite  as  the  struggle  which  a  fixed 
theory  involves. 

I  do  not  know  if  any  analyst  would  use  analysis 
just  in  this  way.  In  the  literature  concerning  it 
there  is  sometimes  a  tendency  in  this  direction.  The 
reason  for  this  is  that  sexuality  is  looked  upon  as  a 
fixed  system  of  forces  which  can  be  repressed,  but 
not  made  free.  Now  since  incest  is  the  nucleus  of 
this  system  of  forces  it  would  be  the  final  conse- 
quence of  the  whole  idea  to  declare  that  one  must 
adapt  one's  self  to  incest  if  one  would  arrive  at  actual 
sexual  freedom  at  all.  It  is  a  fact  that  Freud  has 
already  reached  this  conclusion.  To  me  it  is  hard 
to  make  anything  else  out  of  the  following  lines: 
"It  sounds  unpleasant  and  it  is  still  more  para- 
doxical, but  it  must  nevertheless  be  said,  that,  who- 
ever would  be  really  free  and  therefore  happy  in  the 
love-life  must  give  up  respect  for  women  and  adapt 
himself  to  the  idea  of  incest  with  mother  and  sis- 
ter." *  It  would  have  been  very  considerate  to  say 
the  least,  if  Freud  had  given  an  example  from  his  own 

*  Freud.  Beitrage  zur  Psychology  des  Liebeslebens.  Jahr- 
buch  fur  psychoanalytische  und  psychopathologische  For- 
schung.  Band  IV.  Heft  1. 


236      History  and  Practice  of  Psychanalysis 

knowledge  wherein  any  contemporary  human-being 
had  arrived  at  happiness  and  inner  freedom  by  way 
of  incestuous  practices.  If  a  theory  leads  to  con- 
sequences which  evidently  are  contrary  to  the  most 
simple  facts,  there  must  be  some  falsity  in  its  fun- 
damental principles. 

Jung's  libido-opinion  upon  this  point  must  be  ac- 
knowledged as  an  invaluable  step  ahead.  He  re- 
moves from  the  idea  that  rigidity  which  not  only  is 
strange  to  the  libido  but  to  all  that  concerns  life 
itself.  Instead  he  puts  into  the  idea  the  faculty  for 
transformation  which  is  everywhere  to  be  observed. 
As  I  agree  with  Jung  in  my  opinion  as  to  the  pur- 
pose of  the  treatment  of  the  case  under  considera- 
tion, I  must  also  agree  with  him  on  this  point. 

Every  tendency  which  proclaims  the  unconscious 
mind  to  be  the  reality  and  leads  the  patient  to  adapt 
himself  to  its  mechanism,  I  regard  as  false.  If  a 
choice  must  necessarily  be  made  between  the  un- 
conscious and  the  conscious  it  seems  to  me  evident 
that  the  highest  reality  belongs  to  the  conscious  life. 
If  I  should  give  my  reasons  for  this  belief,  it  would 
lead  to  a  discussion  of  the  nature  of  the  unconscious 
mind  which  would  go  beyond  the  limits  of  this  paper. 
I  must  therefore  confine  myself  to  a  relation  of  the 
leading  thoughts  in  my  actual  talk  with  the  pa- 
tient. 

I  said  to  her  something  like  the  following:  "The 
nucleus  of  your  illness  lies  in  the  fact  that  uncon- 


The  Conscious  Versus  the  Unconscious     237 

sciously  you  have  confounded  the  personality  of 
your  father  with  that  of  the  doctor.  What  you  must 
now  do  is  to  get  a  right  comprehension  of  this  mis- 
take and  then  you  will  also  understand  how  to  make 
yourself  free  from  the  consequences  of  it. 

"Life  is  a  process  of  creation,  through  which  every 
day,  every  minute,  we  endeavor  to  produce  a  value 
out  of  the  material  of  the  time  that  has  passed. 
During  the  puerperal  fever  you  became  separated 
from  the  incessant  progressive  production  of  the 
real  being.  Instead  of  making  use  of  the  present, 
instead  of  advancing  towards  the  future,  you  sank 
back  into  a  time  gone  by.  Present  reality  disap- 
peared, as  far  as  you  were  concerned,  and  that  part 
of  your  life  through  which  you  already  had  passed 
became  your  actual  state  of  existence.  Because  of 
the  illness  you  again  became  a  little,  helpless  child; 
the  nights  of  fever  in  your  childhood  and  the  mem- 
ories bound  up  in  these,  once  more  filled  your  con- 
sciousness. You  again  felt  a  yearning  for  the  bliss 
you  had  experienced  when  your  father  cared  for  you 
in  your  helplessness.  Too  exhausted  to  bring  about 
that  correction  which  belongs  to  the  normal  process 
of  life,  every  longing  fancy  was  changed  into  a  fact. 
When  you  felt  the  doctor  near  you,  his  personality 
was  so  interwoven  with  the  memory  of  your  father 
that  you  were  unable  to  separate  one  thread  from 
another.  As  you  returned  after  your  convales- 
cence, to  reality,  you  brought  with  you  this  fragment 


£38      History  and  Practice  of  Psych  analysis 

of  illusion  into  your  daily  life.  That  you  have 
clung  to  it  with  such  tenacity,  has  a  special  rea- 
son. You  have  told  me  about  a  feeling  of  emptiness 
in  your  life,  about  an  incomprehensible,  haunting 
longing.  On  the  one  hand  your  married  life  has  not 
become  what  you  desired;  on  the  other,  you  have 
revolted  against  filling  up  this  emptiness  with  an 
intrigue  with  any  of  those  for  whom  you  have  had 
a  passing  erotic  feeling.  Notwithstanding  your  con- 
sideration for  husband  and  children,  you  have  felt 
instinctively  that  you  were  not  upon  the  right  road. 
During  your  exhaustion  you  glided  out  of  real  life 
and  then  a  new  way  of  filling  the  emptiness  arose, — 
namely  that  of  fantasy  or  illusion.  Then  out  of 
the  past  you  dug  up  that  situation  which  most  close- 
ly corresponded  to  that  for  which  you  yearned.  You 
wanted  to  be  loved  for  your  own  sake  alone,  setting 
aside  the  question  as  to  whether  or  not  you  were 
useful  to  your  husband.  Such  a  love  as  this,  in  its 
deepest  sense,  exists  only  in  the  heart  of  the  parent 
for  the  child.  Among  grown  people,  a  kind  of 
reciprocity  always  plays  a  part  in  love.  So  you 
saved  yourself  from  being  undeceived  concerning 
what  life  had  in  store  for  you,  by  going  back  to  the 
early  days  of  your  childhood; — then  you  were  torn 
between  two  worlds,  between  that  of  the  child  and 
that  of  the  adult.  But  now  you  must  go  farther  in 
the  creating  of  your  real  existence.  Your  illness 
should  mean  nothing  to  you  excepting  that  you  have 


The  Conscious  Versus  the  Unconscious     289 

gone  back  for  the  purpose  of  fetching  a  lost  value, 
which  you  wanted  to  maintain  in  your  life.  You 
can  be  happy  in  the  fact  that  your  love-life  became 
so  well  fixed  as  it  did  in  your  childhood  years,  in 
your  connection  with  your  father; — but  that  should 
be  a  fact  in  itself,  which  ought  not  to  be  mixed  up 
with  your  life  as  a  married  woman.  Nothing  would 
have  been  more  fatal  than  if  you  had  been  able  to 
give  way  to  your  feeling  for  the  doctor ;  that  would 
have  meant  the  running  after  an  illusion ; — so  your 
life  would  probably  have  come  into  hopeless  confu- 
sion. You  may  be  sure  that  your  married  life  is 
built  up  upon  a  safe  foundation.  If,  however,  it 
has  not  brought  you  entire  gratification,  it  is  not 
impossible  that  it  will  do  so  in  the  future.  This  will 
come  to  pass  the  more,  just  as  you  the  more  find  in 
it  an  outlet  for  all  the  dammed-up  feeling  in  your 
heart.  Apparently  much  depends  upon  your  hus- 
band. If  he  brings  to  you  real  understanding  for 
what  you  suffer,  he  will  be  able  to  fill  the  emptiness 
which  has  hitherto  been  a  factor  in  your  life.  In 
any  case  you  must  make  use  of  all  your  forces  to 
free  yourself  from  this  unreal  part  of  your  life  and 
to  develop  your  married  life  to  the  highest  possible 
degree  of  perfection." 


If  psychanalysis  is  used  in  this  way  as  a  means  by 
which  the  patient  is  helped  to  come  back  to  reality 


240      History  and  Practice  of  Psychanalysis 

and  if  it  is  regarded  as  the  desired  conscious  adap- 
tation to  life,  the  treatment  will  not  be  carried  on  so 
irrelevantly. 

For  example  as  regards  the  length  of  time  needed. 
The  contention  is  often  made  that  psychanalysis  is 
a  very  tedious  method.  But  what  makes  this  tedi- 
ousness  necessary  is  the  accumulation  of  material 
from  the  unconscious  mind.  In  confining  one's  self  to 
the  exposition  of  the  unconscious  connections  in 
broad  lines,  the  position  will  be  different.  As  an 
example  I  can  once  more  use  the  case  cited.  As  I 
shall  quickly  show,  this  treatment  reached  as  satis- 
factory a  result  as  could  be  wished  for;  and  for  this 
only  three  hours  were  necessary.  I  make  no  claim 
that  such  great  curtailment  may  as  a  rule,  be  looked 
for,  I  will  only  emphasize  that  under  fortunate  cir- 
cumstances it  is  possible.  What  made  it  possible  in 
this  case  was  the  fact  that  the  disturbance  had  not 
advanced  to  the  state  when  nervous  symptoms  were 
produced.  The  conflict  was  yet  in  a  sort  of  pro- 
longed nascent  state.  If  compulsion-  or  conversion- 
symptoms  had  developed  the  treatment  must  have 
been  of  much  longer  duration.  Under  such  circum- 
stances much  material  is  necessary  for  the  purpose 
of  convincing  the  patient  of  the  real  connections ; 
the  facts  which  show  that  the  interpretation  is  the 
correct  one  must  be  brought  up  over  and  over  again. 
And  this  may  take  years. 

But  there  is  still  another  thing  which  may  make 


The  Conscious  Versus  the  Unconscious 

the  treatment  tedious  and  that  is  the  fact  that 
psychic  changes  come  about  slowly.  .  Opposing  such 
curtailment  as  was  reached  in  this  case,  it  may  be 
asserted  that  in  the  course  of  days  or  weeks  no 
result  can  be  observed.  The  neurosis  is  not  a  lim- 
ited episode  in  the  life  of  the  patient.  The  neurosis 
is  a  thread  that  starts  at  birth  and  ends  with  death. 
The  treatment  brings  about  a  change;  the  value  of 
this  change  really  can  be  appreciated  only  when  a 
view  over  the  whole  life  is  obtained.  The  greatest 
change  is  a  change  from  a  negative  to  a  positive 
state  of  existence.  The  purpose  is  reached  when  the 
neurotic  condition  has  been  transformed,  so  that  it 
serves  in  life  as  do  other  forces.  But  this  as  a 
general  thing,  comes  about  only  through  develop- 
ment after  the  treatment.  Only  examination  of  what 
goes  on  in  the  inner  life  of  the  patient  after  a  con- 
siderable lapse  of  time  subsequent  to  the  end  of  the 
treatment,  can  give  an  insight  into  its  importance. 
In  order  to  more  closely  explain  this  point  I  will 
come  back  to  the  case. 

In  spite  of  the  purely  practical  advantages  of  the 
manner  in  which  the  treatment  of  this  case  could 
be  curtailed,  it  seems  to  be  significant  in  another 
way,  viz:  in  regard  to  the  matter  of  the  transfer- 
ence. 

The  transference  of  the  father-complex  to  the  per- 
sonality of  the  doctor  is  a  scientific  fact;  but  I  do 
not  ascribe  to  this  process  the  therapeutic  value 


242      History  and  Practice  of  Psychanalysis 

which  is  generally  accorded  it.  No  case  can  more 
plainly  show  than  can  this  case,  what  transference 
fundamentally  means  to  the  patient.  In  this  par- 
ticular case  an  illusion  was  brought  into  the  pa- 
tient's life  which  became  the  nucleus  for  compulsion- 
neurosis  ; — if  circumstances  are  seldom  so  evident  as 
in  this  case,  I  nevertheless  believe  that  transference 
generally  means  something  of  a  similar  nature,  that 
is  to  say,  a  confusion  in  the  creation  of  the  real 
existence.  Life  is  composed  of  genuine  connections, 
not  of  imago-connections.  The  claim  is  made  that 
the  transference  is  broken  up  during  the  course  of 
the  treatment.  But  is  the  patient  not  overrated  on 
this  point?  If  an  individual,  in  the  course  of  some 
years,  has  confided  all  his  secrets  to  another  and 
permitted  this  other  to  look  into  all  his  thoughts,  all 
his  feelings, — a  psychological  connection  becomes 
established  which  neither  by  command  nor  by  analy- 
sis can  be  broken  off.  Fundamentally  there  are  only 
two  'possibilities : — either  the  patient  must  arrange 
a  connection  with  the  analyst  similar  to  that  which 
the  Romanist  occupies  in  connection  with  his  confes- 
sor, or  else  the  connection  must  suddenly  be  broken 
off,  which  alternative  for  the  patient  means  as  a  rule 
a  severe  catastrophy.  The  first  alternative  is  more 
agreeable  for  the  patient,  the  second  for  the  doctor, 
but  both  are  so  difficult  that  a  third  possibility  seems 
to  be  necessary.  Such  a  one  arises  in  the  way  in 
which  the  connection  with  the  doctor  is  reduced,  and 


The  Conscious  Versus  the  Unconscious     243 

also  as  much  as  possible,  the  transference  upon  him ; 
no  real  arrangement  ever  takes  place  at  all,  but  the 
doctor  disappears  as  soon  as  his  role  as  intermediary 
between  the  patient  and  reality  is  played  out. 

Against  this  way  of  making  use  of  psychanalysis, 
some  objections  may  be  made.  In  the  first  place  it 
may  be  asserted  that  this  is  not  psychanalysis,  and 
it  is  not  if  the  word  is  confined  within  the  limits 
used  by  Freud.  But  it  must  be  so  regarded,  never- 
theless, because  analysis  of  the  psychic  confusion 
was  absolutely  necessary  for  the  recovery  of  the  pa- 
tient. Without  clear  comprehension  of  the  transfer- 
ence and  regression  no  one  would  have  been  able  to 
help  in  this  case. 

In  the  second  place  it  may  be  said : — psychanaly- 
sis endeavors  to  give  the  patient  power  over  the  un- 
conscious ;  the  extension  of  consciousness  never  can 
be  injurious.  It  must  therefore  be  regarded  as  a 
fault  of  principle  to  confine  analysis  to  narrow 
boundaries,  etc. 

Regarding  the  first  point  it  must  be  maintained 
that  psychotherapy  in  general  tries  to  increase  the 
power  over  life.  But  power  over  life  and  power  over 
the  unconscious  ought  not  to  be  considered  as  iden- 
tical. Making  a  patient  live  over  again  hundreds 
of  analerotic  memories  from  childhood  does  not  mean 
necessarily  the  giving  to  him  of  higher  power  over 
his  present  life.  It  may  mean  so,  if  this  complex 
has  acted  as  an  obstructive  force  in  his  life;  unless 


244      History  and  Practice  of  Psychanalysis 

this  is  the  case,  such  analysis  has  just  the  contrary 
effect  to  that  after  which  it  strives.  It,  in  such  a 
case,  directs  the  attention  and  through  this,  the  phys- 
ical energy,  to  past  unessentials,  instead  of  turning 
the  energy  towards  things  of  the  future  which  are 
essential; — and  by  so  doing  the  power  over  life  is 
diminished. 

The  discussion  of  this  subject  as  well  as  of  sim- 
ilar objections  has  but  slight  interest.  The  question 
in  hand  is  a  practical  one  and  everything  hangs  upon 
the  answer  given  by  the  immediate  practical  results. 
Had  I  not  obtained  good  results  in  the  case  I  have 
here  set  forth,  I  should  have  kept  to  a  more  dog- 
matic way  of  using  psychanalysis.  Some  further  ex- 
planation of  the  case  seems  to  me  to  be  suitable 
for  throwing  light  upon  the  question  and  for  refuting 
possible  objections. 

I  have  not  seen  the  patient  since  the  treatment  as 
herein  described,  was  concluded.  But  a  year  and  a 
half  later  I  received  a  letter  from  which  I  may  quote 
some  lines; — not  only  because  I  look  upon  them  as 
confirmation  of  the  correctness  of  my  opinion,  but 
chiefly  because  they  give  a  more  intimate  glimpse 
than  any  description  at  second  hand  can  give,  of 
that  which  took  place  within  her  mind  after  that 
time.  If  anyone  should  perhaps  scoff  at  the  some- 
what fantastic  style  in  which  this  letter  is  written,  I 
will  add  that  the  patient  belonged  to  a  family  from 
which  sprang  a  great  poet,  and  that  she  herself  had 


The  Conscious  Versus  the  Unconscious     245 

been  brought  up  in  an  atmosphere  of  poetry.  But 
if  anyone  draws  the  conclusion  from  this  rather 
gushing  letter,  that  the  patient  after  treatment,  was 
just  as  hysterical  as  before,  I  shall  reply,  that  an 
analyst  or  physician,  has  nothing  to  do  with  the 
personality  of  the  patient;  his  task  only  is  to  help 
the  patient  to  come  into  that  right  connection  with 
life  in  which  he  originally  was  created, — into  inti- 
mate touch  again  with  what  life  itself  means  and  al- 
ways must  mean. 

The  letter  was  as  follows: — 

Saved — absolutely  and  forever —  I  send  you 
greeting,  in  greatest  surety  and  most  thankful 
memory.  There  is  no  power  which  cannot  be  used 
to  a  higher  value.  In  this  fact  is  found  the  entire 
unity  between  me  and  my  husband,  which  has  strug- 
gled through  to  victory. 

That  night  after  taking  leave  of  you,  something 
happened  to  the  child-wife,  whose  path  crossed  yours 
in  X.  For  this  I  want  to  try  to  find  an  understand- 
able expression.  That  which  in  my  mind  had  been 
divided  into  two  observers,  each  always  making  a 
different  judgment;  into  two  wills — separated  en- 
tirely in  one  moment,  the  one  from  the  other,  and 
my  thought  took  the  direction  which  you  had  pointed 
out.  On  the  one  hand  there  was  I,  myself,  alive,  con- 
scious, undivided, — on  the  other  hand  was  the  dead 
illusory  part  of  me,  the  morbid  excrescence,  the 
parasite.  Reality  and  unreality  were  torn  apart. 
What  an  experience !  What  an  intoxicating  feeling 
of  freedom!  Was  this  health?  Could  life  be  so 


246      History  and  Practice  of  Psychanalygis 

wonderful?  Do  well  people  know  what  it  is  they 
have?  What  injustice  against  those  who  fight  a 
double  fight!  Make  free  a  bird  from  its  cage  and 
ask  if  it  thanks  you! 

Still  on  the  side  of  reality  something  was  left 
which  threatened  me  with  a  struggle.  The  power 
which  was  hidden  in  it  must  be  turned  into  another 
direction.  Its  very  roots  must  be  forked  out.  Dear- 
er than  the  dearest  at  this  moment  seemed  to  me  to 
be  the  object  for  this  struggle.  To  give  it  up  was 
the  same  as  to  give  up  my  own  existence — or  to  say 
the  least,  all  further  unfoldment  of  that  existence. 
But  out  of  the  unexplored  depths  a  voice  cried  to  me, 
with  the  power  of  the  Eternal: — "Look  not  there! 
Look  here!  Dare  to  take  the  leap!  It  means  more 
than  your  life."  .  .  .  The  act  is  the  growth  of  the 
decision;  if  he  (my  husband)  would  but  give  me 
the  chance  to  speak !  Driven  by  an  irresistible  neces- 
sity the  wife  seized  the  opportunity;  she  laid  bare 
the  facts,  she  implored  forgiveness  as  only  one  does 
who  looks  death  in  the  face.  And  she  met  with  sim- 
ple honesty,  love  of  truth  and  respect!  ...  It 
seemed  to  me  finally  as  if  all  my  weal  and  woe  hung 
upon  the  first  syllable  he  uttered.  He  might  kill 
me, — anything  but  silence.  That  I  could  not  have 
borne.  He  answered:  "Forgive  me; — the  fault  was 
mine."  Then  welled  forth  the  stream  which  like  a 
cleansing  bath  flowed  over  our  souls,  over  our  des- 
tinies, over  the  years  gone  by,  over  days  and  nights, 
hours,  minutes,  seconds  .  .  .  the  stream  which  made 
everything  pure,  which  renewed  and  strengthened. 
And  which,  united  with  the  freest  of  bonds,  thus 
bound  us  together.  .  .  .  And  yet  there  was  some- 
thing, this  woman  would  have: — to  meet  with  some 


The  Conscious  Versus  the  Unconscious      247 

one  like  herself  who  could  rightly  estimate  the  thing 
which  was  crystallizing  in  her  mind;  with  some  one 
who  could  understand  that  which  had  been  discovered 
and  appreciated  by  a  stranger.  Still  remained  then 
an  expression  of  the  desire  "to  be  loved  for  her  own 
sake  alone."  And  was  this  very  thing  not  looming  in 
the  distance, — did  she  not  begin  to  be  sensible  of  that 
for  which  she  so  passionately  had  longed?  .  .  .  Since 
then  everything  has  been  like  a  Te  Deum.  .  .  . 
Everything,  from  the  smallest  to  the  greatest,  has 
become  inestimably  full  of  meaning.  Everything,  in 
the  great  whole,  has  found  its  place.  With  folded 
hands  the  child-wife  has  gone  her  way, — as  if  she 
were  looking  beyond  herself — as  if  the  reins  had 
been  taken  in  hand  by  the  conscious  will,  while  she 
heard  a  decided  command: —  Not  there — no,  here 
must  you  go !  Greater  depths  must  you  penetrate ! 
Self-sacrifice  ,  ,  , 


VII 


EXTRACT  FROM  A  CASE-HISTORY 

THE  following  is  the  essential  history  of  a  case, 
in  the  treatment  of  which  I  was  successful  in 
dissolving  analytically,  a  strongly  constituted  sys- 
tem of  persecution  of  ten  years  standing,  and  in  giv- 
ing the  patient,  an  unmarried  woman  of  fifty-three 
years  of  age,  complete  comprehension  of  her  illness. 
Since  the  end  of  the  treatment  in  April,  1910,  this 
patient  has  exhibited  no  trace  of  mental  disease  or  of 
mental  weakness.  It  will  be  my  effort  here  not  only 
to  give  a  description  of  the  patient  before  and  after 
the  treatment  she  received  from  me,  but  also  and 
chiefly,  to  try  to  make  plain  how  the  change  in  her 
mentality  came  about.  I  shall  thus  endeavor  to 
trace  out  the  forces  which  had  been  in  action  during 
the  formation  of  the  illness  and  also  those  through 
which  it  was  broken  up. 

The  patient  came  to  see  me  for  the  first  time  on 
December  10th,  1909.  She  brought  with  her  a  let- 
ter from  Miss  K.,  a  woman  who  is  famous  in  the  so- 
called  feminist  movement.  This  letter  the  patient 

248 


Extract  from  a  Case-History  249 

asked  me  to  read.  I  found  that  it  was  partly  an 
assurance  that  neither  the  head  of  the  firm  in  which 
the  patient  was  employed,  nor,  so  far  as  the  writer 
knew,  anyone  else,  had  ever  entertained  a  deroga- 
tory opinion  of  the  patient;  partly  the  letter  was 
written  to  earnestly  advise  the  patient  to  consult 
me  for  the  purpose  of  a  chance  of  being  made  free 
from  her  wrong  way  of  thinking. 

The  patient  at  once  assured  me  that  she  had  not 
come  to  me  to  talk  over  what  might  be  revolving 
in  her  mind.  She  said  that  for  many  years  she  had 
suffered  from  struma,  and  that  because  of  this  she 
was  exceedingly  nervous.  She  hoped  that  I  might 
possibly  be  able  to  help  her  by  means  of  hypnotic 
treatment.  She  had  been  told  that  such  treatment 
had  sometimes  been  successful  in  causing  goitre  to 
disappear.  If  the  nervousness  which  was  caused  by 
this  trouble  could  be  lessened,  she  felt  that  she  might 
perhaps  be  able  to  better  resist  the  people  who  per- 
secuted her.  It  had  come  to  the  point  where  she  must 
get  some  help,  for  now  there  was  no  limit  to  the 
insolence  of  these  people.  The  situation  in  which  she 
found  herself  was  simply  unbearable. 

I  asked  her  some  questions  about  the  letter. 

She  told  me  that  she  had  had  the  temerity  to  write 
to  Miss  K.,  knowing  that  she  was  a  friend  of  the 
manager  of  the  office  in  which  she,  the  patient,  was 
employed,  and  feeling  that  matters  had  reached  a 
point  where  this  manager  must  take  some  action 


250      History  and  Practice  of  Psyclianalysis 

regarding  the  daily  misconduct,  there  directed 
against  herself.  All  complaints  of  her  own  had  ac- 
complished nothing.  She  had  also  formerly  believed 
that  Miss  K.  was  herself  a  central  point  in  the  con- 
spiracy against  her,  particularly  as  she  was  sure 
that  Miss  K.  had  sown  many  of  the  seeds  of  this  con- 
spiracy during  her  travels  on  the  continent.  The 
contents  of  the  letter,  however,  had  caused  the 
patient  much  astonishment.  Nevertheless  if  it  were 
actually  a  fact  that  Miss  K.  knew  nothing  about 
this  persecution  of  which  she  was  the  victim,  it  would 
not  in  the  least  alter  things. 

Other  evidences  were  innumerable,  pouring  in  upon 
her  daily  from  every  direction.  She  plainly  consid- 
ered it  superfluous  to  tell  me  anything  about  this, 
as  naturally  I  must  already  know  her  history  and 
the  details  of  that  persecution  to  which  she  was 
subjected. 

Upon  my  denial  of  all  such  knowledge,  the  pa- 
tient again  seemed  much  surprised  and  at  first  dis- 
inclined to  credit  me.  However  she  permitted  herself 
to  be  persuaded  that  I  actually  was  in  ignorance  of 
the  matter.  Gradually  I  drew  her  into  a  conversa- 
tion concerning  this  persecution,  which  I  may  here 
condense  as  follows: 

She  noticed  the  persecution  through  various  kinds 
of  signs, — as  for  instance,  people  scraping  with  their 
feet,  making  peculiar  movements  with  the  legs  and 
arms,  showing  her  pencils,  scissors  and  similar  ol>- 


Extract  from  a  Case-History  251 

jects  for  the  express  purpose  of  insulting  her;  but 
the  worst  thing  was  that  people  stuck  out  their 
tongues  at  her  in  a  manner  that  was  quite  unmis- 
takable. In  the  morning  as  soon  as  she  made  her 
appearance  in  the  street,  this  thing  began.  So  it  was 
everywhere.  She  could  not  go  into  a  shop  where  she 
was  known.  If  she  was  obliged  to  make  a  purchase 
she  must  seek  some  distant  shop  where  she  could  hope 
that  she  was  still  unrecognized.  Sometimes  this  ruse 
succeeded  once.  But  upon  her  second  visit  she  al- 
ways noticed  that  these  shop-keepers  too,  had  be- 
come involved  in  the  conspiracy.  With  the  conduc- 
tors on  the  street-cars  it  was  just  as  bad.  After  a 
great  strike  which  had  taken  place  five  years  before, 
when  all  the  conductors  who  before  that  time  had  an- 
noyed her,  had  been  dismissed,  she  had  hoped  at  first 
that  those  newly  taken  on,  might  assume  no  part  in 
such  misconduct.  But  within  a  few  days  they  too 
began.  The  worst  place  of  all  was  the  office  in  which 
she  was  employed.  The  cashier  there  was  a  real 
devil ;  he  egged  on  the  others  and  was  the  ring-leader 
of  the  whole  thing.  Each  time  he  passed  the  door 
he  made  a  sign  outside.  The  assurance  given  by 
Miss  K.  in  her  letter  that  the  manager  had  no  part 
in  all  this,  was  of  no  value  at  all.  He  also  had  stuck 
out  his  tongue  at  her;  she  had  seen  it  many  times. 
In  the  restaurant  where  she  was  accustomed  to  dine, 
the  thing  had  become  insupportable ;  as  soon  as  she 
entered  the  place,  all  the  people  there  began.  Even 


252      History  and  Practice  of  Psychanalysis 

her  nearest  friend,  Miss  D.,  in  whom  she  had  long 
hoped  to  find  protection,  had  become,  some  months 
prior  to  her  visit  to  me,  her  open  enemy.  None 
of  the  other  diners  in  the  restaurant  any  longer  gave 
her  greeting  when  she  entered.  She  had  many  proofs 
that  all  had  gone  over  to  the  enemy.  At  this  time 
she  would  now  be  going  without  her  dinner  altogether 
had  not  a  niece  asked  her  to  come  to  her.  In  that 
house  she  felt  herself  fairly  secure,  although  she  had 
seen  signs  of  the  persecution  in  the  two-year-old 
daughter  of  the  house ;  an  impudent  maid  had  en- 
ticed the  child  into  it.  The  patient  lived  with  her 
mother  where,  fortunately,  the  persecutors  gener- 
ally left  her  in  peace. 

In  order  that  I  should  not  believe  she  was  exag- 
gerating she  would  tell  me  at  once,  (this  was  at  her 
second  visit)  ;  that  her  persecution  had  a  real  cause. 
There  are  so  many  people  who  at  any  cost,  try  to 
prevent  a  woman  from  doing  as  she  pleases  with  her 
life.  She  had  had  an  intrigue  with  a  man.  This 
was  fully  within  her  right  and  she  did  not  in  the 
least  regret  it.  She  had  wanted  to  live  like  a  real 
woman  and  she  had  done  so.  But  such  a  thing  people 
could  not  endure.  This  was  the  foundation  of  the 
entire  history;  she  had  been  forced  out  of  society; 
she  might  as  well  say  that  she  had  been  condemned 
to  death.  Her  persecutors  constantly  brought  her 
punishment  to  bear  upon  her.  She  asked  me  if  I  were 
acquainted  with  the  history  of  Miss  X.  This  poor 


Extract  from  a  Case-History  253 

girl's  persecutors  had  succeeded  in  getting  out  of 
her  doctor  the  secret  that  she  was  pregnant;  when 
knowledge  of  this  betrayal  came  to  the  girl,  she  had 
committed  suicide.*  The  patient  believed  that  it  was 
the  intention  of  her  persecutors  also  to  drive  her  to 
suicide.  She  believed  that  they  would  sooner  or  later 
succeed.  Using  all  her  strength  she  felt  herself  now 
powerless  to  resist.  During  these  ten  years  the  con- 
spiracy had  become  more  and  more  extensive.  She 
knew  very  well  one  of  its  most  active  centers.  This 
was  The  Woman's  League  Society.  She  assured  me 
that  it  was  a  fact  that  this  society  was  a  veritable 
inquisition.  It  was  situated  close  to  the  school-house 
and  was  an  agency  for  shop-people,  hospital  em- 
ployees, etc.  It  had  influence  everywhere  and  so  was 
able  to  lead  the  persecution  against  her  in  all  direc- 
tions. The  members  of  the  League  spied  with  a  dili- 
gence hardly  credible.  Thus,  as  soon  as  she  visited 
a  new  shop,  the  employees  received  orders  to  insult 
her. —  Formerly  for  many  years  she  had  been  a 
teacher.  She  had  been  offered  a  position  as  princi- 
pal in  one  of  the  largest  of  the  schools  for  girls. 
The  schools  also  belonged  to  the  worst  class  of  her 
persecutors.  She  knew  exactly  which  scoundrels 
were  organizing  the  persecution  there.  She  also  had 
been  a  journalist,  and  she  assured  me  that  beyond 
doubt,  the  persecution  from  which  she  suffered  had 
at  first  been  spread  through  the  press.  Everybody 
*  This  history  I  know  to  be  true. 


254      History  and  Practice  of  Psychanalysis 

knew  her  there.  Of  especially  great  importance  had 
been  a  caricature  of  her  which  had  appeared  in  the 
Christmas  number  of  "Puck,"  1899,  and  an  article 
in  "Hvad  Nytt"  in  February,  1900,  wherein  she  had 
been  sharply  attacked.  At  that  time  she  had  been 
unable  to  open  a  newspaper  without  discovering  at- 
tacks and  insinuations  against  herself  which  of 
course  everybody  understood.  This  still  was  a  com- 
mon occurrence.  A  conference  at  the  Journalist's 
Club  at  which  her  case  had  been  discussed  had  had 
great  effect.  From  an  anonymous  letter  in  which 
she  had  been  accused  of  the  most  atrocious  things, 
she  had  seen  quite  clearly  that  she  had  been  con- 
demned. The  letter  she  had  immediately  burned, 
hoping  thus  to  forget  it ;  but  she  had  not  succeeded. 
There  had  been  times  when  the  persecution  had  been 
less  intense.  But  these  times  had  been  when  her 
enemies  were  gathering  new  strength,  so  that  after- 
wards it  had  become  more  bitter  than  ever.  In  the 
year  1903  there  had  seemed  to  begin  a  change  for 
the  better,  but  since  1906  the  conspiracy  had  spread 
wider  and  wider.  Particularly  had  it  grown  worse 
since  an  operation  she  had  been  obliged  to  undergo 
in  June,  1908. 

I  asked  the  patient  if  she  ever  had  been  able  to 
assure  herself  that  other  people  noticed  the  signs 
of  which  she  spoke. 

She  replied  that  the  signs  all  belonged  to  a  sign- 
language  which  is  wide-spread.  Her  family  had 


Extract  from  a  Case-History  255 

made  attempts  to  persuade  her  that  the  whole  thing 
was  imagination.  But  the  proof  she  had  for  her 
knowledge  was  so  overwhelming  that  she  could  not 
for  one  moment  doubt  the  reality  of  it.  Once  she 
had  requested  her  niece  to  follow  her  to  the  post- 
office  and  to  carefully  watch  the  post-mistress  so 
that  she  might  be  convinced  for  herself.  The  woman 
had  stuck  her  tongue  out  at  her  from  ear  to  ear! 
Afterwards  the  niece  had  said  that  she  had  not  ob- 
served this,  but  that  could  not  possibly  be  true. 

I  asked  the  patient  if  in  her  earlier  life  she  had 
been  subjected  to  such  persecution. 

She  answered  no, — not  at  all.  She  always  had 
been  upon  most  friendly  terms  with  her  fellow-men. 

Upon  further  questioning  concerning  the  begin- 
ning of  her  trouble,  she  told  me  she  had  noticed  as 
far  back  as  the  spring  of  the  year  1899,  that  she 
was  looked  at  in  a  peculiar  way;  sometimes  also 
people  had  offered  her  insults.  The  signs  she  had 
first  begun  to  notice  some  months  later  in  X-Burg, 
whither  she  had  followed  the  man  with  whom  she  had 
been  in  love.  She  had  returned  home  hoping  these 
signs  were  unknown  there ;  but  she  very  soon  discov- 
ered that  her  hope  had  been  in  vain.  In  the  month  of 
February,  1900,  these  signs  had  broken  upon  her  so 
from  all  sides  that  she  could  not  at  all  protect  her- 
self. .  .  .  Some  years  prior  to  this  time  she  had 
passed  through  an  experience  which  had  destroyed 
her  courage,  and  at  the  time  mentioned  she  was 


256      History  and  Practice  of  PsycTianalysis 

still  suffering  from  this  experience.  But  her  general 
mental  condition  had  not  been  one  of  depression. 
Formerly  she  had  been  of  a  very  cheerful  disposi- 
tion nor  had  she  been  unusually  vacillating  in  tem- 
perament. 

Regarding  heredity,  the  patient  had  much  to  re- 
late, whereof  I  shall  note  only  the  most  significant 
points.  Her  father  had  been  the  result  of  a  passing 
intrigue  with  a  farm-girl.  He  was  a  clever  and  tal- 
ented, but  very  peculiar  man.  He  had  given  up  an 
excellent  business  as  a  watch-maker,  in  order  to  start 
several  newspapers,  of  which  at  least  one  became 
of  importance.  Always  he  had  innumerable  schemes 
in  his  head,  of  which  very  few  amounted  to  anything. 
He  had,  for  example,  erected  a  "hygienic  bakery" 
and  for  several  years  he  had  worked  at  a  plan  for  a 
carriage  which  was  to  run  on  rails  automatically 
laid  out  for  itself ;  he  had  taken  out  innumerable  pat- 
ents on  different  inventions.  Most  of  them  were 
quite  impossible.  For  instance  he  had  devised  an 
apparatus  for  refreshing  soldiers  during  the  march. 
This  apparatus  consisted  of  a  rubber  bulb  fitted  be- 
tween the  foot  and  the  sole  of  the  shoe,  to  which  was 
attached  a  tube,  which  ran  up  to  the  top  of  the 
head;  from  this  tube,  at  every  step,  a  current  of  air 
was  blown  into  the  face  of  the  wearer.  His  latest 
patent  had  been  a  device  for  drawing  the  blankets 
up  over  the  head  at  night.  He  was  a  man  who 
quarreled  with  everybody  and  who  was  almost  always 


Extract  from  a  Case-Hutory  257 

involved  in  processes  of  law.  He  now  was  somewhat 
more  careful  about  such  matters,  as  once  he  had 
come  very  near  to  committing  perjury.  All  the  half- 
sisters  and  brothers  of  this  man  were  most  peculiar. 
One  of  the  brothers,  while  very  intelligent,  was  hos- 
tile to  other  people,  adventurous,  a  pathological  liar 
and  often  mixed  up  in  quarrels.  Another,  who  is 
still  alive,  is  a  notorious  litigant.  A  sister  who  be- 
came famous  as  a  writer,  had  been  unable  as  a  child 
to  separate  reality  from  fantasy;  she  used  to  come 
home  and  relate  things  about  herself  which  she  had 
made  up,  but  in  which  she  entirely  believed.  Still 
another  had  suffered  from  an  inability  to  resist  go- 
ing round  and  round  in  street-cars;  finally  she  had 
thrown  herself  from  a  train  and  been  killed.  An- 
other had  been  quite  insane  and  had  died  in  an 
asylum.  On  the  mother's  side  there  had  been  nothing 
abnormal.  The  mother  was  still  living  and  at  eighty 
years  of  age  was  in  the  best  of  physical  and  mental 
health. 

Of  the  twelve  brothers  and  sisters  of  the  patient, 
five  had  died  young.  All  those  living  were  more  or 
less  nervous.  One  brother  had  for  years  suffered 
from  aphony;  he  also  imagined  that  he  was  perse- 
cuted. One  sister  had  phobia  for  different  things. 
Two  other  sisters  had  undergone  deep  changes  in 
their  personalities.  One,  in  her  youth,  had  been  of 
a  cold,  careless  nature,  but  had  married  happily 
and  now  apparently,  was  a  saint,  who  already  existed 


258      History  and  Practice  of  Psychanalysis 

in  the  other  world.  She  was  a  theosophist,  vege- 
tarian, etc.  Among  the  children  of  the  relatives 
also  nervous  diseases  and  peculiarities  were  common. 
One  youthful  neurasthenic  was  determined  to  kill  his 
mother  because  she  had  brought  children  into  the 
world,  although  she  knew  that  she  belonged  to  a 
most  degenerate  family.  Law-suits  had  been  with- 
out number  between  the  different  members  of  the 
family. 

.  .  .  The  thing  most  noticeable  at  first  about  the 
patient  was  a  restless,  strained  expression ;  this  domi- 
nated her  behavior,  her  features  and  especially  her 
eyes.  Her  intellectual  capacity  was  excellent.  In 
speaking,  thoughts  came  in  strong  logical  order. 
Undoubtedly  she  was  a  very  talented  woman  and 
her  ideas  regarding  things  having  no  connection  with 
her  insane  imagery,  were  excellent.  As  to  the 
question  of  megalomania  it  was  noticeable  that  both 
as  teacher  and  as  journalist,  she  had  been  very  highly 
appreciated ;  but  her  feeling  for  herself  had  exceeded 
natural  limits. 


In  the  original  description  of  this  case  *  I  have 
explained  my  opinion,  that  it  must  be  regarded  as  a 


*  "Zur  Radikalbehandlung  der  Chronischen  Paranoia," 
Bjerre.  Sonderabdruck  aus  dem  Jahrbuch  fur  Psychoanaly- 
tische  und  Psychopathologische  Forschungen,  111  Band,  2. 
Halfte. 


Extract  from  a  Case-History  259 

case  of  true  paranoia;  but  here  I  shall  confine  my- 
self to  a  curtailed  description  of  the  treatment. 

This  treatment  began  with  the  first  visit  of  the 
patient  to  my  office.  The  formation  of  a  rapport 
between  doctor  and  patient  is  perhaps,  the  most 
difficult  thing  to  achieve,  in  a  case  wherein  the  pa- 
tient feels  hatred  towards  the  whole  world  and  sees 
in  every  human  being  a  new  enemy.  That  from 
the  very  start,  this  patient  felt  herself  calm  in  my 
consulting-room  and  was  able  to  speak  easily  to  me, 
is  a  fact.  The  reason  for  this,  I  am  unable  with  cer- 
tainty, to  explain.  The  letter  of  recommendation 
from  Miss  K.  possibly  had  had  some  suggestive  in- 
fluence. But  I  believe  that  the  effort  I  made  to  put 
myself  as  fully  as  possible,  in  her  place,  was  the 
most  important  factor.  I  did  not  allow  myself  to 
show  the  slightest  doubt  as  to  the  reality  of  the  per- 
secution of  which  she  felt  herself  the  victim,  but  spoke 
with  her  about  these  things  as  about  any  other  facts. 
I  so  completely  was  able  to  play  this  part  that  she 
felt  that  at  last  she  had  found  someone  who  under- 
stood her  situation  and  did  not  approach  her  with 
the  usual  weakminded  objections.  I  thus  gained  a 
peculiar  position,  which  showed  itself  partly  in  the 
fact  that  she  really  listened  to  what  I  had  to  say, 
partly  in  the  fact  that  I  was  not  added  to  the  flock 
of  her  pursuers.  It  is  true  that  she  explained  to  me 
how  on  one  of  her  first  visits  she  also  had  noticed 
in  me  signs  of  persecution  and  how  she  had  come 


260      History  and  Practice  of  Psychanalysi* 

very  near  considering  me  too  in  the  light  of  an 
enemy;  but  fortunately  I  had  succeeded  in  nipping 
this  suspicion  in  the  bud  and  in  persuading  her  that 
she  had  nothing  to  fear  from  me.  Nevertheless  I 
had  been  by  no  means  sure  that  she  would  return  to 
me  again,  after  that  time.  The  fact  of  her  doing 
so  was  probably  due  to  no  other  reason  than  that 
it  amused  her  to  talk  with  me.  At  first  it  gave  her 
a  sense  of  freedom  to  find  herself  understood;  then 
gradually  I  drew  her  into  general  conversation.  I 
showed  a  lively  interest  in  her  family  history,  in 
her  childhood,  etc.  Imperceptibly  I  began  to  inter- 
pret what  she  told  me,  in  words  in  which  she  sus- 
pected no  intention.  That  everything  I  said  to  her 
however,  was  suggested  after  a  certain  plan,  is  self- 
evident.  After  a  little  I  began  to  make  some  ex- 
planations in  which  she  was  greatly  interested.  As 
she  told  me  facts  concerning  her  parents,  I  referred 
to  the  question  of  heredity,  explaining  how  a  child 
may  be  born  with  some  defect,  which  can  have  a  deep 
influence  upon  its  after  life  without  its  being  con- 
scious of  it.  I  gave  her  examples  of  this  which 
stimulated  her  after- thoughts.  We  spoke  much 
about  her  childhood.  During  that  time  the  patient 
had  resided  in  a  small  provincial  town.  Her  recol- 
lections of  this  home  were  pleasant,  but  only  because 
of  her  mother,  who  made  everything  about  her  home- 
like and  happy.  At  that  time  the  position  of  the 
father  in  the  family  was  that  of  a  stranger.  Against 


Extract  from  a  Case-History  861 

his  schemes  the  patient  had  been  just  as  much  op- 
posed as  were  all  the  other  members  of  the  family. 
"We  acquired,"  she  said,  "a  habit  of  looking  upon 
him  as  a  wrong-doer  who  needlessly  interfered  with 
the  business  and,  with  his  unfortunate  ideas,  de- 
stroyed our  financial  status."  And  yet  the  patient 
had  entertained  a  certain  admiration  for  her  father's 
cleverness,  imagination  and  energy.  She  admitted 
to  me  that  in  many  ways  she  was  like  him — particu- 
larly in  her  love  of  change.  He  also  had  awakened 
her  literary  interest.  For  her  mother  the  patient  had 
always  had  the  warmest  attachment.  ...  I  told  her 
some  of  the  remarkable  facts  concerning  the  uncon- 
scious influence  of  parents  upon  their  children  and 
how  such  influence  may  often  be  much  stronger  than 
anyone  suspects ;  how  a  child  may  imitate  the  traits, 
or  even  almost  the  whole  destiny  of  a  parent,  without 
in  the  least  understanding  it ;  how  for  instance  such 
a  tendency  as  quarrelsomeness  may,  little  by  little, 
find  its  way  into  the  child's  mind  and  constantly 
acquire  a  stronger  hold  there. 

Among  the  first  impulses  of  her  life  the  patient 
recollected  a  very  lively  fancy.  In  her  play  she  lived 
so  thoroughly  in  fictitious  places  and  situations,  that 
it  was  often  difficult  for  her  to  return  to  connection 
with  the  real.  One  thing  she  used  to  imagine  was 
that  pins  were  horse-men  and  that  the  pin-cushion 
was  a  forest  through  which  they  galloped  in  the 
night.  When  she  had  grown  older  she  had  lived  in 


262      History  and  Practice  of  Psychanalysis 

day-dreams.  Then  she  had  been  the  princess  in  the 
sleeping  castle,  waiting  for  the  prince  to  come  who 
should  awaken  her  with  a  kiss ; — always  he  came  from 
some  unknown,  distant  land  and  had  taken  her  with 
him  far  from  the  things  of  every-day  life. —  Such 
tales  gave  me  the  opportunity  to  speak  with  her 
about  imagination  and  reality  and  about  the  urgent 
need  of  keeping  sharply  defined  the  subjective  and 
objective  worlds.  She  admitted  that,  like  her  aunt, 
she  had  had  difficulty  in  doing  this ;  but  she  insisted 
that  this  had  played  no  part  in  her  life. 

Relations  between  herself  and  her  brothers  and 
sisters  had  been  very  pleasant.  Especially  had  the 
patient  been  devoted  to  one  sister,  two  years  her 
senior.  In  this  sister's  companionship  she  had  found 
the  protection  she  had  so  needed  in  her  younger  days. 
At  that  time  she  had  been  very  bashful  and  uncertain 
of  herself.  In  company  she  had  been  wont  to  hide 
herself  behind  this  sister  and  let  her  do  the  talking 
for  both;  she  had  nicknamed  this  sister  her  "trum- 
pet." Both  had  early  made  up  their  minds  never 
to  marry;  they  would  instead  "marry  each  other." 

At  the  time  when  they  came  to  S to  live,  the 

patient  having  been  then  thirteen  years  of  age, — 
they  had  hunted  out  a  house  in  which  they  were 
agreed  upon  the  intention  to  live  as  "old  maids." 
Young  men  afterwards  frequented  the  house  in  an  en- 
tirely unaffected  way;  flirtations  came  about  but 
were  soon  forgotten. 


Extract  from  a  Case-History  263 

When  the  patient  was  eighteen  the  great  experi- 
ence of  her  life  came.  Soon  before  this  she  had,  in 
co-operation  with  her  sister  begun  to  make  up  little 
"newspapers"  which  were  circulated  among  their 
immediate  circle  of  friends  and  acquaintances.  This 
of  course  had  been  done  anonymously,  and  they  had 
had  much  amusement  out  of  it.  As  a  joke  they  fin- 
ally had  inserted  a  marriage  notice  in  a  public 
newspaper.  One  of  the  replies  to  this  had  been  the 
beginning  of  a  correspondence  which  had  lasted 
without  interruption  for  twenty  years,  during  all 
of  which  time  the  patient  had  never  personally  en- 
countered her  correspondent,  although  he  lived  in 
the  same  city.  Her  connection  with  this  unknown 
had  been  a  source  of  great  happiness  to  her.  She 
had  anticipated  his  letters  with  all  the  eagerness  and 
delight  incident  to  love.  Not  only  had  she  been  at- 
tached to  his  man  with  her  whole  soul;  he  also  had 
been  connected  in  some  peculiar  manner  with  her 
erotic  life.  With  him  she  had  felt  that  she  would 
be  able  to  marry;  to  him  she  could  give  herself. 
He  was  the  fairy  prince  of  whom  she  had  always 
dreamed.  During  her  twenties,  she  had  made  the 
acquaintance  of  another  man  with  whom  she  felt 
herself  in  sympathy  and  who  loved  her.  She  also 
had  had  a  feeling  of  love  for  him,  but  after  seven 
years  of  doubt  and  inner  strife,  she  had  broken 
with  him.  Evidently  she  had  felt  that  she  never 
could  quite  free  herself  from  the  writer  of  the  letters 


History  and  Practice  of  Psychanalysis 

with  whom  she  was  forever  connected  by  a  kind  of 
mystic  bond.  The  patient  was  unable,  even  at  the 
time  I  saw  her,  to  speak  of  this  correspondence  with- 
out tears  coming  into  her  eyes  and  she  insisted  that 
in  spite  of  everything,  it  had  been  the  thing  of 
greatest  import  in  her  whole  life.  The  destruction 
of  this  connection  had  been  her  most  painful  experi- 
ence. It  had  occupied  some  years  and  many  things 
had  played  a  part  in  it.  But  one  only  had  been  de- 
cisive. When  at  last  in  her  thirty-eighth  year  she 
had  met  the  man  personally  at  a  party,  she  at  once 
understood  that  she  had  completely  deceived  herself. 
The  ideal  she  had  so  long  believed  to  have  had  exist- 
ence behind  the  letters,  was  not  there  at  all.  Instead 
she  saw  an  entirely  common-place  man,  who  at  the 
same  time  was  in  the  midst  of  a  liaison  with  her  own 
youngest  sister.  This  had  been  too  hard  a  blow  for 
her.  She  wished  never  to  see  him  again.  Then  she 
had  begun  to  hate  him  and  to  grow  bitter  against 
the  whole  world. 

I  dwelt  long  upon  this  very  significant  part  of  her 
life.  I  showed  her  how  deeply  this  unusual  experi- 
ence had  buried  itself  in  her  nature  and  suggested 
to  her  that  this  might  produce  morbid  displacement 
between  fantasy  and  reality.  This  she  could  take 
no  credence  in ;  with  the  exception  of  the  goitre,  she 
assured  me  that  she  always  had  been  in  excellent 
health. 

Her  external  life,  during  all  these  years  she  had 


Extract  from  a  Case-History  265 

filled  in  the  following  manner : —  After  the  termina- 
tion of  her  schooling  she  had  assisted  her  father  for 
some  years  in  the  editing  of  his  papers.  At  the  age 
of  twenty-three  she  had  gone  for  a  period  of  three 
years,  to  a  seminary,  after  which  she  worked  for 
thirteen  years  as  a  teacher — sometimes  in  private 
families,  sometimes  in  the  higher  schools  for  girls. 
She  had  suffered  much  from  the  constraint  of  the 
seminary,  nor  was  the  work  of  a  teacher  suited  to 
her  temperament.  Nevertheless,  as  I  have  said  be- 
fore she  had  everywhere  been  liked.  A  position 
which  had  been  offered  to  her  as  principal  of  a  school 
she  had  refused,  because  she  had  been  unable  to 
resign  herself  to  remaining  always  a  teacher. 

After  she  had  freed  herself  from  the  writer  of 
the  letters,  she  had  felt  herself  sufficiently  strong  to 
take  a  decisive  step.  She  had  given  up  forever  her 
position  as  a  teacher  and  taken  a  place  on  the 
staff  of  a  weekly  paper.  Here  she  had  worked  for 
two  years  and  during  that  time  had  acquired  a  posi- 
tion of  importance.  Without  any  definite  reason  she 
had  resigned  this  also  in  October,  1898 ;  she  had  not 
wished  to  feel  bound  down  to  anything.  Until  the 
following  April,  she  then  had  had  occasional  work 
on  different  newspapers,  in  insurance  offices,  etc. 
During  all  these  years  she  had  come  into  closer 
touch  with  many  people;  partly  her  friends  were 
families  of  high  social  position  whose  children  she 
had  taught,  partly  they  were  in  the  circle  of  teach- 


266      History  and  Practice  of  Psychanalysis 

ers,  but  chiefly  were  they  colleagues  of  the  press. 
For  the  purpose  of  study  she  had  visited  Germany, 
England  and  France.  Everywhere  she  had  made 
acquaintances  without  difficulty.  She  had  a  lively 
interest  in  many  subjects, — hislory,  politics,  litera- 
ture, etc.  More  than  all  had  she  become  interested 
in  the  so-called  feminist  movement  and  at  every  op- 
portunity she  had  defended  the  rights  of  women. 

I  pointed  out  to  her  the  importance  of  the  fact 
that  during  all  this  period  of  her  richest  develop- 
ment, she  had  been  connected  with  a  kind  of  work 
which  really  had  been  unsuited  to  her.  Her  dissatis- 
faction during  all  this  period  probably  had  its 
strongest  root  in  her  sexual  restraint.  Had  she  been 
able  to  concentrate  her  forces  upon  some  work  which 
would  have  been  in  accord  with  her  desires  and  her 
talent,  this  dissatisfaction  to  a  certain  degree  would 
have  been  effaced.  And  what  would  have  been  even 
more  important,  she  would  have  lived  her  life  in 
closer  connection  with  the  external  world.  For  some 
sort  of  activity,  which  at  the  same  time  makes  an  in- 
dividual free  and  of  use  to  others,  is,  next  to  the 
sexual-life,  the  strongest  bridge  between  individual 
existence  and  the  world.  As  far  as  the  sexual-life 
went  she  had  already  been  driven  from  reality  to 
fantasy  and  afterwards  the  same  thing  had  occurred 
where  social  activity  was  concerned.  If  the  daily 
work  does  not  satisfy,  everyone  is  apt  to  fill  that 
life  with  day-dreams.  The  lack  of  ability  in  the 


Extract  from  a  Case-History  267 

patient,  which  had  really  existed  from  the  beginning, 
to  apprehend  objectively,  had  become  in  the  course 
of  years,  still  more  effaced.  Her  childish  habit  of 
living  in  a  world  of  dreams,  she  plainly  had  never 
become  free  from. —  She  was  unable  to  deny  that 
all  this  was  true,  but  that  it  could  have  any  deeper 
significance  she  could  not  at  all  believe. 

In  the  winter  of  1898-1899  she  had  begun  the 
liaison  with  Mr.  C.  who  had  come  to  town  for  busi- 
ness reasons.  She  had  been  obliged  to  visit  him  at 
his  hotel,  in  order  to  execute  a  business  commission. 
As  early  as  her  second  visit  he  had  made  advances 
to  her  which  she  had  not  resisted; — not  at  all  be- 
cause she  felt  any  love  for  the  man — that  she  had 
not  imagined  for  a  moment.  But  she  wanted  to 
really  live  the  real  life  of  a  woman  and  she  had  so 
made  use  of  the  opportunity  which  here  came  in  her 
way.  In  the  place  of  that  happiness  which  she  had 
lost,  she  would  at  least  enjoy  experience  and  knowl- 
edge. This  was  her  right  and  she  had  never  re- 
gretted having  taken  it.  In  April,  1899,  she  had 
followed  Mr.  C.  to  X-Burg,  a  town  on  the  con- 
tinent, for  the  avowed  purpose  of  taking  a  position 
in  his  office.  There  she  had  remained  until  Novem- 
ber when  the  liaison  came  to  an  end  and  she  had  re- 
turned home.  In  her  home  town  she  had  already 
remarked  that  people  spied  upon  her.  Once  when  she 
was  about  to  leave  a  hotel  she  had  noticed  that  a 
waiter  made  a  grimace.  He  had  without  doubt,  been 


268      History  and  Practice  of  Psychanalysis 

listening  at  the  door  and  from  this  beginning  her 
persecution  had  spread  among  the  waiters — one  of 
its  worst  breeding-places. 

When  I  now  began  more  closely  to  question  her 
concerning  these  first  signs  of  the  persecution,  one 
thing  which  I  had  already  noticed  in  my  former 
talks  with  the  patient,  became  more  clear  to  me: 
she  tried  always  to  keep  away  from  the  treatment  of 
details ;  as  a  rule  she  was  unable  to  look  at  one  thing 
by  itself  and  to  keep  that  one  thing  fixed  in  her 
thought,  until  we  had  thoroughly  done  with  it.  When 
she  arrived  at  a  certain  point  in  her  narrative,  the 
threads  of  thought  became  tangled  and  the  whole 
thing  was  wiped  out.  I  tried  to  prevent  this  and 
many  times  called  her  attention  to  the  fact  by  say- 
ing, "No,  don't  tell  me  anything  more.  Let  us  keep 
to  this  until  we  are  ready  to  go  on !"  This  irritated 
her  very  much  and  that  I  had  come  upon  a  weak 
spot  here  was  plainly  evident;  she  was  many  times 
angry,  but  I  did  not  give  in.  Finally  she  said,  "I 
cannot  think  with  exactness;  I  have  never  really 
thought  with  my  intellect,  only  with  my  feelings. 
If  we  are  going  to  get  any  farther,  you  must  let  me 
think  in  my  own  way." 

I  explained  to  her  the  absolute  necessity  of  using 
the  intellect  for  the  purpose  of  thinking.  I  told  her 
that  if  she  had  never  been  able  to  do  this,  it  was 
high  time  for  her  to  try;  and  I  added  a  long  lec- 
ture on  thinking  with  the  feelings,  so  that  her  ideas 


Extract  from  a  Case-History  269 

upon  the  subject  might  be  made  clear.  I  described 
to  her  how  the  mind  must  impair  in  case  one  never 
makes  an  effort  to  cleanse  the  thoughts  of  tempo- 
rary moods  and  sensations,  and  the  dangers  con- 
nected with  such  a  course.  Finally  she  permitted 
me  to  linger  long  enough  on  every  detail  until  I  was 
thoroughly  convinced  that  the  thing  was  fully  worked 
out  in  her  mind.  In  short,  I  had  to  teach  her  how 
to  think.  It  was  a  tiresome  piece  of  re-education, 
from  which  she  many  times  would  have  liked  to  run 
away.  When  we  went  on  with  her  narrative  I  com- 
pelled her  to  re-live  every  experience — not  as  she  her- 
self recalled  it,  but  as  she  would  have  lived  through  it 
if  at  the  time,  she  had  been  able  to  see  clearly  and 
distinctly. 

In  regard  to  the  first  time  she  had  noticed  the 
signs  of  persecution,  she  now  told  me  the  follow- 
ing:—  She  had  had  to  attend  a  horse-race  in 
X-Burg  in  order  to  report  it  for  her  paper.  On 
the  reporters'  stand,  she  had  been  spoken  to  by  an 
elegantly  dressed  woman  who  happened  to  sit  next 
her.  She  presently  noticed  that  this  woman  was  the 
object  of  peculiar  attention  from  the  men.  She  ob- 
served how  one  man  after  the  other  made  strange 
signs  to  her,  especially  with  the  tongue.  At  first 
she  had  been  at  a  loss  to  understand  it,  but  it  pres- 
ently became  clear  to  her  that  these  signs  must  have 
a  hidden  sexual  meaning.  She  had  moved  away  from 
the  woman  without  learning  her  name,  and  she  did 


870      History  and  Practice  of  Psychanalysis 

not  meet  her  again. —  During  the  next  few  days 
she  noticed  with  horror  that  people  in  the  streets 
began  to  make  similar  signs  to  herself. 

In  the  course  of  this  talk  I  gave  her,  with  great 
caution,  an  explanation  somewhat  as  follows: 
"Naturally  these  events  may  have  taken  place  exact- 
ly as  you  believe.  That  I  will  not  at  all  deny.  But 
it  seems  also  possible  to  me  that  you  have  been  the 
victim  of  a  very  curious  mistake.  Something  similar 
to  such  a  mistake  we  occasionally  experience  in  a 
lesser  degree  but,  as  a  rule,  it  does  not  attract  our 
attention.  Life  is  very  full  of  illusions  and  many 
people  remain  forever  entangled  in  their  mistakes. 
When  the  experiences  of  today  superimpose  upon 
those  of  yesterday,  we  sometimes  lose  our  conscious 
view,  and  with  it,  control  over  our  own  lives, — we 
became,  that  is  to  say,  play-things  of  unconscious 
motives.  The  more  experiences  accumulate,  the  more 
overwhelming  they  are,  just  so  much  the  more  dif- 
ficult it  is  to  connect  them  at  once  with  the  "I." 
Take  for  instance,  a  case  like  this :  you  may  have  suf- 
fered some  great  loss.  You  travel  in  order  to  forget 
— that  is,  you  try  to  bury  your  trouble  under  a  mass 
of  new  experiences.  You  become  carried  away  by 
these — you  forget  yourself.  Presently  this  new 
stock  of  experiences  melts  in  with  the  old.  Even 
more  clearly  still  can  you  see  this,  if  you  meet  with 
someone  who  makes  a  deep  impression  upon%  you. 
What  one  of  us  has  not  in  youth,  been  so  influenced 


Extract  from  a  Case-History  871 

by  some  great  personality  that  he  has  lost  his  own 
"I"  in  this  other — seeing  with  the  other's  eyes,  writ- 
ing with  the  other's  pen?  It  may  be  years  before 
the  "I"  assimilates  the  accumulated  material — if  it 
ever  succeeds  in  so  doing.  Here  is  a  way  open  for 
trouble,  for  stunting  development,  and  these  things 
are  very  common  occurrences  in  a  lesser  degree.  How 
many  people,  for  instance,  escape  traits  of  alien 
personalities,  which  remain  forever  to  steer  life  into 
wrong  directions,  without  their  being  conscious  of 
such  a  thing?  How  many  people  have  in  their  in- 
most thoughts,  identified  themselves  with  Hamlet  and 
because  of  that  have  been  restrained  in  every  act  of 
life?  In  the  healthy  person  there  are  psychic  ten- 
dencies to  assure  against  such  misfortunes;  such  a 
one  examines  the  inner  life  and  discovers  wherein 
lies  the  wrong.  But  in  order  to  accomplish  that, 
one  must  have  a  clear  vision  and  be  able  to  think 
with  keenness.  So  if,  as  you  have  done,  one  has 
thought  only  with  the  feelings  and  has  worked  no 
clear  way  out  through  the  mass  of  befogging  ex- 
periences, he  becomes  fertile  soil  for  the  seed  of  all 
kinds  of  mistakes.  And  such  dangers  are,  like  all 
other  dangers,  so  much  the  greater,  the  less  one  is 
prepared  to  cope  with  them.  The  worst  kinds  of 
troubles  arise  simply  because  a  stock  of  experiences 
creep  into  the  consciousness  without  being  noticed. 
If  anyone  has  exerted  a  strong  influence  upon  you, 
without  your  having  remarked  this  influence,  then, 


872      History  and  Practice  of  Psychanalysis 

not  only  the  thoughts  of  this  person,  but  also  his 
personality  and  even  more,  his  destiny,  can  be  so 
mixed  in  the  depths  of  the  unconscious  mind  with 
your  own  "I"  that  you  cannot  separate  one  thread 
from  another.  Unconsciously  you  identify  yourself 
with  that  other.  In  such  a  way,  for  instance,  one 
often  assumes  the  pains  of  another. —  In  order  to 
fully  understand  this  it  is  necessary  to  take  one 
very  important  fact  concerning  the  unconscious 
mind  into  consideration.  The  unconscious  mind  is 
not  so  centralized  as  is  the  conscious ;  in  it  the  con- 
glomeration of  earlier  experiences  are  not  bound  to- 
gether into  one  "I."  Under  peculiar  circumstances 
such  a  conglomeration,  which  is  called  a  complex, 
may  attain  a  certain  independence,  may  grow  and 
acquire  an  insidious  influence  upon  the  conscious  "I." 
Just  as  under  normal  circumstances,  this  "I"  takes 
sustenance  from  the  external  world  and  assimilates 
everything  that  agrees  with  it,  so  an  unconscious 
complex  can  attract  to  itself  everything  that  is  in 
accord  with  it,  without  our  noticing  it  in  the  least 
degree.  So  we  may  come  under  the  power  of  the  un- 
conscious mind." 

I  was  successful  in  making  these  ideas  clear  to  the 
patient  only  after  long  explanation  and  by  means  of 
many  examples  taken  from  everyday  life,  as  well  as 
from  pathological  psychology.  She  was  greatly  in- 
terested in  all  this ;  but  that  it  should  have  any  spe- 
cial application  to  herself  she  could  not  at  all  be- 


Extract  from  a  Case-History  273 

lieve.  But  by  the  suggestion  of  these  facts,  lines  of 
thought  were  drawn  through  her  mind,  along  which 
her  further  thought  could  work  out  to  a  deeper 
comprehension  of  the  pathological  processes  in  her 
life. 

I  continued  my  conversation  with  her  as  follows : 
"You  will  now  perhaps  better  be  able  to  under- 
stand your  peculiar  experience  in  X-Burg.  You 
had  lived  there  for  some  months  in  a  liaison  which 
dominated  your  whole  thought.  In  this  liaison  you 
had  endeavored  to  find  a  substitute  for  the  happiness 
which  you  had  lost,  and  by  means  of  it  you  desired 
above  all  to  demonstrate  for  yourself  the  right  of  a 
woman  to  live  her  sexual-life.  But  this  intrigue  of 
yours  had  to  be  kept  secret ;  had  it  become  known  it 
would  have  ruined  you  forever.  You  were  unable  at 
the  time  to  deny  to  yourself  that  you  were  in  a 
state  of  anxiety.  (The  patient  had  admitted  to  me 
that  she  had  fear  concerning  the  result  of  her  manner 
of  life)  ;  you  had  surely  pictured  to  yourself  what 
the  consequences  might  be.  Above  all  you  feared 
that  this  intrigue  might  further  degrade  you;  that 
sexuality  once  brought  into  action  might  drive  you 
farther  and  farther.  Your  demonstration  of  the 
rights  of  women  told  you  that  you  were  within  your 
full  legitimate  field ; — but  the  woman  in  you  also  told 
you  that  you  were  running  into  grave  danger.  In 
the  conscious  mind  there  arises  in  every  such  case, 
a  complex,  which  strikes  a  strong  note  of  fear  and 


274      History  and  Practice  of  Psychanalysis 

anxious  watching.  In  this  state  of  mind  you  were, 
when  you  came  across  that  unknown  woman  on  the 
reporters'  stand.  From  her  dress  and  general  ap- 
pearance you  unconsciously  concluded  that  there 
might  reasonably  be  some  doubt  as  to  her  respect- 
ability. Your  conscious  personality  was  not  at- 
tracted toward  her;  intentionally  you  failed  to  seek 
her  acquaintance.  'By  accident'  you  got  a  seat 
beside  her  on  the  stand.  But  that  is  as  much  as  to 
say  that  the  complex  in  your  mind  felt  itself  at- 
tracted toward  her;  such  accidents  do  not  exist. 
The  complex  suggested  to  you,  like  Mephistopheles : 
— 'such  another  you  too  will  become ; — seek  the  com- 
pany in  which  you  belong!'  As  a  flirt,  this  woman 
must  attract  peculiar  notice ;  that  you  unconsciously 
concluded,  and  upon  this  point  you  strongly  concen- 
trated your  attention.  You  perceived  at  once  that 
you  were  right.  Perhaps  it  was  so  in  reality.  But 
if  it  had  not  been  it  would  have  seemed  so  to  you. 
We  always  see  what  we  wish  to  see.  But  even  more 
do  we  see  everything  which  a  complex  forces  upon 
our  attention;  hallucinations  easily  arise  in  this 
manner.  Possibly  some  one,  or  even  many,  had 
laughed  at  this  woman,  in  such  a  way  that  the  tongue 
could  be  seen.  No  matter  how  it  came  to  pass  you 
have  observed  peculiar  movements  of  the  tongue  and 
this  has  made  a  deep  impression  upon  you.  To  sum 
up: — an  unconscious  complex  unnoticed  by  you, 
drew  this  woman  into  your  mind  and  associated  her 


Extract  from  a  Case-History  275 

so  strongly  with  itself,  that  unconsciously  you  iden- 
tified yourself  with  her.  In  the  days  that  followed 
this  identification  tried  to  weave  itself  into  your  own 
personality.  Tfoe  consequence  was  that  you  too 
longer  saw  with  your  own  eyes,  but  with  hers ;  and  so 
people  in  the  streets  made  the  same  movements  with 
the  tongue  to  you  that  they  had  made  to  her." 

The  patient  received  this  explanation  with  a  con- 
temptuous smile.  She  meant  by  this  to  intimate  that 
very  possibly  something  of  this  sort  might  take 
place,  but  that  she,  herself,  never  could  have  made 
such  a  mistake ;  she  could  believe  the  evidence  of  her 
own  eyes,  etc.,  etc.  I  made  no  attempt  to  convince 
her;  on  the  contrary  I  assured  her  that  it  was  very 
probable  that  she  was  right ;  that  I  did  not  at  all  say 
that  things  must  be  as  I  had  suggested,  but  that  it 
was  a  possibility  with  which  one  must  reckon.  In 
order  to  make  full  investigation  of  anything,  all 
possibilities  must  be  put  to  proof, — not  merely  the 
ones  most  probable. 

I  took  up  the  matter  of  the  tongue  and  ques- 
tioned her  as  to  any  unpleasant  experiences  in  which 
that  member  had  played  a  part  in  her  life.  She  re- 
called among  other  things,  that  once  in  the  street, 
she  had  met  a  man  who  suddenly  had  become  mad 
and  who  screamed  and  stuck  his  tongue  out  of  a 
horrible  looking  mouth.  This  picture  had  burned 
itself  with  painful  clearness  into  her  memory. 

I  explained  how  such  an  emotional  picture  always 


$76      History  and  Practice  of  Psychanalysis 

with  great  ease  becomes  reconstructed  and  how  it 
has  a  tendency  to  associate  everything  with  itself 
which  is  in  any  way  similar  to  it.  "Probably,"  I 
went  on,  "you  never  would  have  noticed  these  slight 
movements  of  the  tongue  if  in  your  mind  there  had 
not  already  existed  an  over-determined  picture  of  an 
outstretched  tongue."  But  this  also  was  too  much 
for  her  to  believe. 

I  now  talked  with  her  about  the  unintentional 
symptom  acts  common  to  everyday  life.  How  peo- 
ple continually  make  little  unconscious  movements, 
which  are  not  especially  noticed  by  others.  To  these 
belong  the  habit  of  moistening  the  lips  with  the 
tongue.  This  phenomenon  is  like  the  blind  spot  on 
the  retina: — it  remains  unnoticed  unless  attention 
is  directly  called  to  it.  By  means  of  an  over-de- 
termined picture  of  an  out-stretched  tongue,  I  ex- 
plained to  the  patient  that  her  attention  had  been 
too  strongly  attracted  to  every  small  movement  of 
the  tongue — attracted  to  the  very  smallest,  with  the 
same  surety  that  a  piece  of  iron  is  attracted  to  a 
magnet ;  and  that  whereas  she  had  thought  the  phe- 
nomenon an  objective  one,  it  was  in  reality  subjec- 
tive.—  She  laughed  heartily  at  an  idea  so  absurd. 

Continuing,  I  explained  to  her  how  naturally  one 
accompanies  a  forceful  thought  with  some  gesture. 
If  one  thinks  intensely  about  the  tongue  it  is  hard 
to  keep  it  entirely  still.  To  this  is  added  another 
fact;  all  such  movements  are  very  contagious.  If, 


Extract  from  a  Case-History  277 

for  instance,  anyone  in  a  company,  begins  to  yawn, 
soon  one  after  the  other  does  the  same  thing.  The 
connection  thus  might  be  formulated  as  follows: — 
because  she — the  patient,  had  fixed  her  attention  on 
the  outstretched  tongue,  she  had  herself  stretched 
out  her  own  tongue  unusually  often.  And  this  she 
had  done  just  at  those  times  when  she  feared  that 
someone  else  might  do  it.  The  movements  of  her 
own  tongue  thus  had  been  contagious  to  others.  So 
that  which  she  had  observed,  had,  in  reality,  come 
from  herself. 

The  patient  looked  upon  this  idea  as  inexpressibly 
funny.  She  would  not  even  believe  that  I  meant  it 
in  earnest.  Every  effort  I  made  to  analyse  the  com- 
plication from  this  side,  met  with  insurmountable 
resistance.  The  gestures  she  had  seen,  were,  and 
would  remain,  signs  of  a  sexual  persecution, — for 
this  her  proof  was  abundant  and  unequivocal.  She 
had  even  read  in  many  books  by  modern  writers,  that 
such  signs  are  known  generally,  and  therefore  the 
whole  thing  became  still  more  clear.  S.,  for  example, 
tells  of  a  man  who  made  signs  like  these  to  a  woman, 
as  he  drank  her  health  at  dinner.  Unfortunately 
such  things  have  a  foundation  in  fact,  and  could  not 
be  explained  away.  The  other  gestures  were  equally 
proofs  in  themselves. 

I  will  here  let  the  patient  go  on  with  her  own 
story : 

When  she  had  left  X-Burg  she  had  hoped  that 


278      History  and  Practice  of  Psychanalysis 

her  love-affair  was  known  only  in  that  town  and 
that  she  would  not  be  exposed  to  further  persecu- 
tion in  other  places.  But  she  had  quickly  discov- 
ered that  the  sign-language  was  also  known  in  her 
native  land  and  was  there  to  be  used  against  her. 
She  soon  learned  that  her  love-affair  was  a  matter 
of  common  gossip  at  home,  as  well.  This  was  made 
manifest  to  her  in  many  ways.  Wherever  she  went, 
people  talked  about  her  and  if  she  turned  her  back, 
they  laughed.  An  article  which  she  had  written  for 
one  of  the  weekly  papers  was  not  accepted, — a 
thing  which  never  before  had  happened.  In  the 
editorial  rooms  she  was  strangely  treated, — the 
editor  even  had  left  the  room  when  she  entered  it. 
Former  acquaintances  showed  her  the  cold  shoulder, 
sometimes  not  even  greeting  her  in  the  street.  It 
had  been  all  the  harder  to  bear  when  she  had  dis- 
covered that  she  could  not  trust  even  her  oldest 
friends.  In  the  beginning  she  had  conjectured  that 
the  rumor  concerning  her  had  been  privately  spread 
about.  She  had  recommended  as  her  successor  in  the 
office  at  X-Burg,  a  country-woman  of  her  own  and 
she  believed  that  this  woman  had  also  since  been 
seduced  and  that  she  had  then  tried  in  this  manner 
to  avenge  herself  for  having  been  sent  to  the  place. 

At  last  had  come  a  fatal  day  in  February,  1910, 
when  she  finally  understood  clearly  that  all  she  had 
hitherto  observed  had  been  merely  the  harbinger  of 
a  general  persecution.  As  she  already  had  related, 


Extract  from  a  Case-History  879 

the  thing  had  rushed  in  upon  her  from  all  sides. 
Everywhere  she  went  she  saw  the  signs  and  every- 
where people  talked  about  her  and  avoided  her.  She 
was  positive  that  her  persecutors  had  made  use  of 
public  agencies.  Her  love-affair  had  become  known 
to  the  whole  town  and  she  had  been  utterly  con- 
demned by  society,  utterly  ostracised.  It  was  her 
fate  to  be  hunted  to  death.  All  because  she  had  done 
something  which  it  was  her  perfect  right  to  do.  She 
had  then  made  up  her  mind  to  turn  against  every- 
body and  to  shut  herself  up  within  herself.  So  the 
thing  had  gone  on  from  year  to  year  until  at  last 
she  and  her  mother  had  come  to  live  entirely  alone. 
Meanwhile  the  conspiracy  against  her  had  spread  all 
over  Europe;  she  even  had  certain  proof  that  in 
America  also,  centers  of  this  persecution  existed. 
She  complained  bitterly  that  society  should  so  treat 
an  innocent  woman. 


I  now  broke  the  ground  for  exact  examination  and 
test  of  every  single  proof  of  the  persecution.  I 
asked  her  to  describe  in  detail  every  occurrence  as 
completely  as  she  was  able  to  recall  it.  I  began  with 
the  public  proofs  and  then  went  on  to  those  of  a 
more  private  nature.  As  it  would  be  superfluous  to 
explain  all  this  material,  I  shall  give  only  a  few 
examples. 


280      History  and  Practice  of  Psychanalysw 

To  begin  with  she  had  told  me  that  a  caricature 
in  the  Christmas  number  of  "Puck"  (1899)  and 
an  article  in  "Hvad  Nytt"  in  February,  1900,  had 
been  of  great  significance  in  her  case. 

I  telephoned  to  the  office  of  "Puck"  to  get  a  copy 
of  the  number  in  question.  I  found  that  this  periodi- 
cal had  not  yet  come  into  existence  in  the  year 
1899.  I  tried  vainly  to  find  the  caricature  else- 
where. I  then  told  the  patient  of  my  failure  and 
begged  her  to  help  me  without  fear,  in  my  search. 
She  succeeded  in  finding  it  in  another  humorous 
paper  published  in  1902 ;  but  she  now  made  the  dis- 
covery that  the  text  had  been  aimed  at  another 
journalist  instead  of  at  herself.  She  also  found  the 
article  in  "Hvad  Nytt"  for  me.  It  had  to  do  with 
a  lecture  on  the  subject  of  morality  and  contained 
no  personal  insinuations  of  any  kind  whatsoever. 
The  patient  was  compelled  to  admit  that  she  had 
made  here  two  indubitable  mistakes  in  memory.  She 
was  surprised,  but  otherwise  it  made  no  impression 
upon  her.  The  fact  of  the  persecution  remained 
absolutely  unchanged.  It  had  simply  come  about 
through  other  means  than  those  she  had  credited. 
Perhaps  it  was  the  outcome  of  the  February  meeting 
of  the  Society  of  Journalists,  where  her  case  had 
been  discussed,  or  possibly  exclusively  through  ar- 
ticles in  the  newspapers,  to  which  at  the  time,  she 
had  attached  little  importance. 

As  an  instance  of  the  persecution  emanating  from 


Extract  from  a  Case-History  281 

her  own  friends  (as  she  saw  matters)  I  relate  the 
following : 

A  family,  all  the  members  of  which  had  been  her 
friends,  who  lived  in  a  provincial  city,  came  to  town 
and  stopped  at  a  hotel  there.  When  she  called  upon 
them  she  had  been  received  with  customary  hospi- 
tality. There  had  been  the  usual  little  pleasantries 
and  the  best  of  good  feeling  between  them.  Sud- 
denly a  waiter  had  appeared  and  summoned  the  hus- 
band out  of  the  room.  When,  after  some  time,  he 
returned,  he  had  appeared  quite  changed.  He  had 
been  cold  and  disagreeable  and  had  so  influenced 
the  wife  and  daughter,  by  means  of  secret  signs,  that 
they  also  had  altered  their  attitude  toward  her. 
The  conversation  had  languished  and  she  had  felt 
constrained  to  take  her  leave.  So  her  association 
with  this  family  had  come  to  an  end.  When  they 
had  come  to  town  again  later  on,  she  had  not  even 
been  informed  of  the  fact.  In  her  opinion  the 
waiter  had  called  the  husband  out  of  the  room  to 
inform  him  about  herself.  Waiters,  as  I  have  before 
pointed  out,  were  always,  in  the  mind  of  the  patient, 
centers  from  which  information  concerning  her 
spread. 

As  an  explanation  of  this  incident,  I  suggested  to 
her,  the  following : — the  husband,  no  doubt,  had  been 
called  to  the  telephone  by  the  waiter — a  thing  which 
occurs  at  least  once  every  fifteen  minutes  to  most 
business  or  professional  people.  Or  possibly  some- 


282      History  and  Practice  of  Psyclianalysis 

one  was  looking  for  him  personally.  Just  like  every- 
thing else,  this  occurrence  had  at  once  awakened  her 
distrust.  A  suspicion  something  like  this  had  then 
taken  possession  of  her:  "Now  someone  is  going  to 
tell  him  about  me  and  our  friendly  intercourse  will 
end."  Her  attention  had  concentrated  itself  upon 
this  thought,  her  distrust  had  been  ready  to  grasp 
any  detail  and,  by  misconstruing  it,  to  find  in  it  a 
proof. —  When  the  husband  returned  his  thoughts 
had  been  busy  with  some  news  he  had  received. 
The  wife  and  daughter  had  noticed  this  and  had 
been  curious  to  hear  what  was  the  matter.  Per- 
haps even,  they  had  been  expecting  news  of  impor- 
tance. The  members  of  the  family  might  well  have 
grown  silent  because  of  other  reasons  than  the  ones 
she  had  imputed  to  them.  But  because  of  this  si- 
lence she  had  assumed  absolute  evidence  of  the  fact 
that  these  people  too  had  joined  her  persecutors. 
And  she  had  herself,  acted  accordingly.  She  had 
grown  bitter  and  repellant,  she  had  taken  her  leave 
in  a  cold,  offended  manner,  in  fact  she  had  made  it 
plain  that  she  wished  to  have  no  more  to  do  with 
them.  The  family  could  scarcely  do  anything  but 
acquiesce  and  be  silent  about  the  whole  matter. — 
These  and  similar  explanations  the  patient  refused 
to  accept,  because,  in  her  own  mind,  she  knew  bet- 
ter. It  was  impossible  that  she  could  be  so  mistaken, 
etc. 

However  I  went  on  quietly  and  without  interrup- 


Extract  from  a  Case-History  283 

tion.     The  conditions  she  had  observed  in  her  of- 
fice, I  insisted  upon  with  particular  care. 

She  had  told  me  that  the  cashier  there  was  a 
woman-hater;  he  wanted  to  throw  all  women  out 
of  the  office.  Mrs.  L.,  who  died  of  tuberculosis 
in  1909  had  really  been  driven  to  her  death,  she 
asserted,  by  this  man.  The  patient  had  already 
assured  me  that  she  was  not  the  only  one  convinced 
of  this  fact.  The  man  hated  her  too.  After  the 
death  of  Mrs.  L.  things  had  become  even  worse 
than  before.  After  finishing  Mrs.  L.  his  hatred  had 
settled  upon  herself.  Every  time  he  passed  her 
door  he  scraped  with  his  feet. —  I  explained  to  her 
how  many  disputes  naturally  arise  through  the  daily 
friction  brought  about  where  many  people  work  in 
the  same  building.  It  might  have  been  that  the 
cashier  was  a  rival  of  Mrs.  L.  for  the  good-will  of 
the  manager.  But  I  doubted  if  this  could  have  had 
connection  with  her  illness.  "Even  admitting  that 
Mrs.  L.  was  exposed  to  such  persecution,"  I  said  to 
the  patient,  "it  would  not  necessarily  follow  that 
after  her  death,  the  cashier  should  have  begun  to 
persecute  you.  You  may  have  been  deceived  in  that 
idea.  You  recall  how  we  have  spoken  of  your  in- 
clination to  put  yourself  in  the  place  of  someone  else 
— quite  unconsciously,  it  is  true — and  you  recall 
that  I  explained  also  how  one  person  may  for  in- 
stance, feel  the  pains  of  another.  I  have  at  this  time 
under  treatment,  an  old  man,  who  will  serve  as  a  good 


284      History  and  Practice  of  Psychanalysis 

example  of  this  very  fact.  He  suffers  from  pain  in 
the  stomach  and  vomiting;  these  are  in  reality  the 
symptoms  of  the  illness  of  his  dead  wife,  who  had 
cancer  of  the  stomach.  Did  you  not  after  Mrs. 
L.'s  death  take  upon  yourself  the  persecution  which 
in  her  case  may  have  been  a  fact  ?" 

After  this  manner  the  treatment  went  on.  I  saw 
the  patient  every  other  day  until  the  middle  of  Feb- 
ruary, (with  an  interruption  of  two  weeks  after 
Christmas),  or  for  a  period  of  about  seven  weeks. 
The  result  seemed  then  to  be  null.  Many  of  the 
new  experiences  and  points  of  view  I  gave  her  had, 
it  is  true,  awakened  her  astonishment  and  had  mo- 
mentarily shaken  her  position;  but  at  each  subse- 
quent interview  these  successes  had  been  overthrown 
by  her  own  system  and  she  could  then  explain  every- 
thing in  her  own  way.  No  change  for  the  better 
had  come  about  in  her  intercourse  with  those  with 
whom  she  daily  had  to  do, — rather  if  anything, 
the  contrary.  On  New  Year's  Day  she  had  asked  for 
a  private  interview  with  her  manager,  having  deter- 
mined to  tell  him  in  detail  all  about  the  persecu- 
tion and  of  her  desire  that  the  punishment  of  the 
cashier  and  others  might  be  enforced.  The  patient's 
niece,  whom  I  have  before  had  occasion  to  mention, 
succeeding  in  preventing  this  catastrophe.  Other- 
wise the  patient  would  have  lost  her  position  and, 
as  she  was  without  means,  this  must  have  resulted  in 
her  being  sent  to  an  institution. 


Extract  from  a  Case-History  385 

Nevertheless  I  believe  that  in  the  depths  of  her 
unconscious  mind,  a  change  had  already  begun. 
Her  appearance  no  longer  was  so  tense  and  strained ; 
her  voice  no  longer  had  the  tone  of  absolute  cer- 
tainty when  she  spoke  of  the  persecution  and  her 
laughter  had  lost  some  of  its  superciliousness.  I 
felt  that  there  was  a  possibility  that  doubt,  sug- 
gested to  her  in  a  hundred  different  ways,  had  taken 
root  and  was  quietly  growing.  Her  heart  no  longer 
was  in  what  she  said. —  I  resolved  to  venture  upon 
a  decisive  step.  I  boldly  told  her  that  I  myself  had 
begun  to  doubt  that  she  ever  really  had  been  exposed 
to  persecution.  Many  situations  seemed  so  peculiar 
to  me,  that  this  doubt  had  begun  to  worry  me.  I 
wanted  to  see  clearly  into  the  matter.  I  therefore 
asked  her  permission  to  put  myself  in  communica- 
tion with  some  one  who  must  be  cognizant  of  the 
persecution  if  such  a  state  of  things  really  existed. 
I  proposed  a  colleague  whom  I  had  known  for  many 
years  and  who  was  the  friend  as  well  as  the  physician, 
in  her  own  family.  She  had  mentioned  him  to  me 
several  times,  imputing  to  him  a  certain  part  in  the 
spreading  of  her  troubles.  She  now  made  no  objec- 
tion to  my  proposition. 

It  is  unnecessary  to  add  that  this  step  would 
have  been  useless,  unless  the  suggestibility  of  the 
patient  had  grown  enormously  during  the  course  of 
her  treatment.  Undertaken  prematurely  the  result 
>f  such  a  step,  like  so  many  of  a  similar  nature 


286     History  and  Practice  of  Psychanalysis 

before,  would  have  been  entirely  negative.  Now 
however,  the  soil  was  so  well  prepared  that  it  seemed 
possible  to  me  that  such  a  suggestion  might  overcome 
the  strongest  resistance.  In  view  of  this  coming 
examination  I  increased  the  tension  of  the  patient's 
mind  regarding  it,  by  putting  it  off  from  day  to  day. 
Then  I  consulted  with  my  colleague  alone;  he  knew 
that  the  patient  suffered  from  paranoia  and  he  was 
able  to  provide  me  with  some  interesting  details  re- 
garding her  earlier  life. 

On  the  28th  of  February  I  told  the  patient  that 
my  colleague  had  heard  not  the  slightest  thing  either 
of  her  love-affair  or  of  the  persecution  and  that 
he  was  absolutely  convinced  that  no  one  ever  had 
either  thought  or  spoken  evil  about  her.  It  took  me 
quite  half  an  hour  to  impress  this  fact  upon  her. 
She  was  so  amazed  that  she  could  hardly  speak. 
When  she  left  me  it  was  quite  clear  that  my  state- 
ment had  produced  an  effect;  and  at  our  next  con- 
versation I  found  that  this  effect  had  been  greater 
than  I  had  dared  to  hope.  The  struggle  between 
the  complexes  and  the  suggestions  no  longer  ap- 
peared to  be  beyond  our  range  of  vision.  Doubt 
concerning  the  system  of  persecution  was  plainly 
coming  to  the  surface.  This  ignorance  of  such  an  old 
friend  of  the  family  was  the  first  shock  toward 
emancipation.  All  that  which  during  the  course  of 
the  treatment  had  been  sown  with  such  precaution 
and  had  since  been  germinating  in  the  depths  of  her 


Extract  from  a  Case-History  287 

unconscious  mind,  now  began  to  stretch  up  toward 
the  light,  while  the  ground  beneath  "the  system" 
began  to  shake.  Nevertheless  the  patient  by  no 
means  abandoned  her  point  of  view  at  once  and  with 
no  further  effort  to  sustain  it.  She  came  back  with 
the  old  objections.  Still  I  had  won  ground  and  be- 
cause of  her  uncertainty  I  ventured  upon  more  ener- 
getic suggestions.  I  said  no  longer,  "This  or  that 
may  have  been  so ;**  I  asserted :  "This  or  that  came 
about  in  this  way.  Without  the  shadow  of  a  doubt 
you  were  entirely  mistaken." —  I  went  over  all  the 
motives  which  had  been  discussed  before  and  showed 
her  with  compelling  logic,  that  my  interpretation  was 
the  only  one  possible.  I  now  gave  her  little  oppor- 
tunity to  speak,  but  went  on  uninterruptedly  with 
my  new  arguments.  Instead  of  contemptuous  laugh- 
ter, she  listened  to  me  amazed.  She  began  to  get 
some  inkling  of  the  possibility  of  deliverance,  yet  she 
dared  not  believe  in  it.  But  with  every  subsequent 
talk  with  me  this  hope  grew  and  I  assured  her  that 
she  was  about  to  experience  a  complete  inner  en- 
lightenment. If  however  she  must  still  wait  a  little 
for  this  she  must  not  become  impatient. 

"You  must  take  into  consideration  what  an  un- 
precedented development  all  this  implies,"  I  said  to 
her.  "How  long  it  took  people  to  understand 
that  the  earth  revolves  around  the  sun  instead  of  the 
other  way  about !  In  your  case  there  is  in  question 
a  still  deeper  re-valuation  of  ideas.  The  persecution 


288      History  and  Practice  of  Psychanalysis 

grew  into  an  external  fact  for  you.  Now  you  will 
come  to  see  that  it  had  its  roots  in  your  own  mind. 
It  has  been  exclusively  an  inner  fact.  It  has  come 
into  existence  because  of  morbid  displacement  in 
your  unconscious  mind." 

During  this  part  of  the  treatment,  the  inner 
change  in  the  patient  became  more  and  more  evident 
and  what  was  more,  there  came  about  with  it  a 
change  in  her  attitude  toward  the  external  world. 
The  powerful  inner  tension  gave  way  and  the  symp- 
toms grew  less  pronounced. 

She  told  me  that  she  still  saw  the  signs,  but  that 
they  seemed  more  remote  and  that  they  did  not  op- 
press her  as  they  formerly  had  done, — that  she  had 
begun  to  bother  herself  no  longer  about  them.  She 
was  now  able  with  no  great  uneasiness  to  visit  shops, 
even  the  same  shops  wherein  she  had  been  formerly  so 
tormented.  At  the  office  too  things  were  going  bet- 
ter. She  had  found  flowers  on  her  desk  on  her  birth- 
day. They  had  been  placed  there  by  the  daughter  of 
Mrs.  L.,  a  woman  whom  she  always  had  feared  as  a 
secret  enemy.  I  made  her  see  how  formerly  she  would 
have  been  certain  to  have  seen  signs  of  the  persecu- 
tion in  these  very  flowers. —  Even  the  cashier  evi- 
dently had  grown  more  courteous.  At  my  special 
request  she  called  upon  some  former  acquaintances 
and  was  astonished  to  find  among  them  no  ill  will 
against  herself.  At  every  point  I  made  clear  to  her 


Extract  from  a  Case-History  289 

of  course,  the  connection  between  these  apparent 
outer  changes  and  her  own  actual  inner  change. 

On  the  llth  of  March  came  the  most  decisive  step 
in  the  whole  treatment. 

She  began  immediately  upon  her  visit  to  my  of- 
fice, to  relate  to  me  how  during  the  past  few  days, 
two  recollections  had  taken  hold  of  her,  although 
she  did  not  know  why  they  had  come.  For  years 
she  had  not  even  given  a  thought  to  the  occurrences 
in  question,  and  now  with  no  apparent  reason,  they 
stood  pre-eminent, — fully  clear  before  her  conscious 
mind. 

When  she  was  17  years  of  age  she  had  had  a 
friend  a  few  years  her  senior.  This  friend  was  much 
in  love  at  the  time,  but  her  father  had  opposed  her 
marriage  with  the  man.  It  had  been  reported  to  my 
patient  that  this  friend  had  moved  to  a  provincial 
city;  after  some  time,  however,  she  received  a  letter 
telling  her  that  her  friend  was  still  living  in  town, — 
secretly,  in  one  of  the  suburbs — and  was  awaiting 
the  birth  of  a  child.  After  this  event  had  taken 
place,  she  went  one  evening  to  see  her  friend,  in  com- 
pany with  her  own  sister.  This  also  had  been  done 
secretly.  While  there  she  had  met  the  young  father 
and  had  been  quite  enchanted  by  the  blissful  atmos- 
phere which  filled  the  house.  The  whole  circum- 
stance had  made  a  deep  impression  upon  her  and 
had  excited  her  lively  imagination. 


290     History  and  Practice  of  Psyclianalysit 

As  she  spoke  to  me  about  this  matter  I  was  im- 
pressed with  the  idea  that  all  her  girlish  dreams  had 
once  more  come  to  life.  At  the  same  time  she  laid 
so  much  stress  upon  her  indignation  over  the  lies  and 
deceptions  with  which  these  people  had  been  obliged 
to  surround  themselves  in  order  to  escape  persecu- 
tion from  their  neighbors,  that  I  was  forced  to  the 
conclusion  that  the  social  side  of  this  story  had  been 
at  the  time,  of  main  interest  to  her. 

The  second  recollection  was  of  something  which 
had  entered  still  deeper  into  her  life. 

Among  the  girls  with  whom  she  had  been  confirmed 
there  had  been  one  who  was  her  especially  intimate 
friend.  This  girl,  later  on,  had  moved  away  from 
town  and  correspondence  between  the  two  had  grad- 
ually come  to  an  end,  so  that  at  last  my  patient  very 
seldom  had  news  of  her.  In  the  year  1899  the  pa- 
tient heard  accidentally  that  this  friend  was  ill, 
but  she  had  thought  nothing  further  about  the  mat- 
ter. Some  months  later  still,  when  the  patient  was 
living  in  a  boarding-house  in  England,  she  had  read 
in  a  newspaper  that  this  friend  had  been  arrested 
on  charge  of  infanticide ;  the  body  of  the  dead  child 
had  been  found  hidden  in  a  doll's  house.  The  patient 
had  a  strong  feeling  that  her  friend  was  innocent  and 
was  highly  indignant  at  such  infamy.  The  news- 
papers made  a  great  sensation  out  of  the  story  and 
her  friend's  name  was  mercilessly  dragged  through 
the  press.  The  case  was  talked  about  everywhere* 


Extract  from  a  Case-History  291 

An  autopsy,  however,  was  made  upon  the  child  and 
it  was  thus  proved,  without  the  shadow  of  a  doubt, 
that  it  had  been  born  dead.  The  whole  scandal  had 
been  the  work  of  an  official, — a  man  who  was  an 
enemy  of  the  family.  But  because  of  the  scorn  and 
persecution  to  which  she  had  been  subjected  the  poor 
woman  was  completely  broken.  She  would  no  longer 
remain  in  her  native  land,  but  went  to  hide  herself 
somewhere  in  America.  There  she  had  encountered 
many  hardships. 

The  patient  used  the  strongest  words  in  trying  to 
explain  to  me  how  this  story  had  shocked  her.  But 
it  had  not  been  only  because  of  compassion  for  her 
friend;  more  than  all  had  her  sense  of  justice  been 
affronted.  She  had  felt  that  the  matter  was  an  in- 
sult directed  against  her  sex.  She  even  had  desired, 
at  the  time,  to  make  public  interference  in  order  to 
expose  a  code  of  morals,  that  will  condone  such 
treatment  of  a  woman  who  elects  to  decide  the  cir- 
cumstances of  her  own  life. 

After  this  narration  I  asked  the  patient  if  she 
could  not  herself  guess  the  reason  why  such  recol- 
lections had  now  come  to  her,  out  of  her  uncon- 
scious mind.  Hesitatingly  she  then  brought  them 
into  connection  with  all  I  previously  had  explained 
to  her  in  regard  to  morbid  identification,  etc.  She 
called  to  mind  the  incident  at  the  horse-races  in 
X-Burg  and  admitted  that  her  thoughts,  since  she 
had  been  made  to  see  clearly  through  them,  had 


292     History  and  Practice  of  Psychanaly&is 

slowly  worked  out  analogous  experiences.  Without 
a  clear  understanding  of  that  incident*  she  never 
would  have  been  able  to  understand  that  she  had, 
unconsciously,  confounded  her  own  fate  with  that 
of  her  friend. 

I  spared  no  words  in  making  fully  clear  to  her, 
until  she  herself  was  finally  convinced  of  the  truth, 
that  we  now,  on  the  spot,  had  discovered  the  nucleus 
of  her  imaginary  persecution.  What  she  had  expe- 
rienced during  the  past  ten  years  had  been  no  per- 
secution directed  against  herself;  of  such  a  thing 
not  a  trace  existed.  It  had  been  the  persecution 
against  her  friend.  This,  wrongly  brought  into  con- 
nection with  her  own  "I,"  had  amalgamated  in  the 
depths  of  her  unconscious  mind  and  had  been  brought 
to  light  by  the  incident  in  X-Burg.  There  she  had 
herself  been  in  a  position  similar  in  certain  aspects 
to  that  of  her  friend.  She  had  feared  becoming 
gravid  and  unconsciously  had  come  to  the  conclusion 
that  such  a  misfortune  would  bring  about  like  con- 
sequences to  herself.  Then  in  her  unconscious  mind 
had  taken  fire,  the  great  struggle  with  the  opponents 
of  the  rights  of  women  and  she  had  prepared  herself 
to  be  persecuted  and  hunted  down.  Gradually  this 
persecution-complex  had  broken  its  way  through  to 
the  conscious  mind.  Making  use  of  paths  already 
staked  out  for  it,  it  had  usurped  more  and  more  au- 
thority over  her  personality,  and  so  contracted  the 
limits  of  her  life  within  narrower  and  narrower  boun- 


Extract  from  a  Case-History 

daries.  In  this  way  she  had  become  the  victim  of  the 
hallucinations. 

After  she  accepted  this  explanation,  the  feeling 
that  she  had  had  her  long-fettered  feet  made  free, 
seemed  to  take  more  and  more  hold  upon  her  and  she 
found  herself  coming  more  and  more  continually 
into  contact  with  the  outside  world.  Nevertheless 
the  struggle  between  the  complex  and  reality  was  not 
yet  over.  It  was  an  almost  insurmountable  difficulty 
to  carry  through  a  revaluation  of  experiences  which 
had  lasted  for  ten  years.  I  constantly  had  to  sup- 
port the  inner  working  of  her  mind  with  energetic 
suggestions.  In  spite  of  everything,  her  doubts  were 
always  ready  to  be  awakened  and  the  unbelievable 
strength  of  her  illusions  was  ready  to  spring  into 
light.  It  seemed  to  her  impossible  to  think  that  all 
the  thousands  of  evidences  of  the  persecution,  could 
actually  be  false ;  yet  on  the  other  hand  deliverance 
from  all  this  misery  was  so  great  a  happiness,  that 
she  could  scarcely  credit  the  reality  of  its  coming 
to  pass. 

I  finally  felt  obliged  to  make  a  proposition  to  her 
that  she  should  speak  to  one  of  her  imaginary  per- 
secutors. I  selected  for  this  purpose  Miss  D.  who 
had  been  the  last  person  with  whom  the  patient  had 
held  any  communication. 

The  patient  wanted  to  think  this  idea  over.  On 
the  24th  of  March  I  received  a  note,  containing  the 
following  lines :  "I  have  determined  to  take  no  half- 


294      History  and  Practice  of  Psychanalyris 

measures.  I  must  appeal  to  Miss  D.  Her  opinion 
now  seems  necessary  to  me,  if  I  am  to  get  a  clear 
idea  of  my  own  mental  condition  and  of  my  position 
toward  the  world.  Will  you  please  write  to  her 
about  it?" 

On  the  first  of  April  when  I  told  the  patient  that 
I  had  talked  about  her  with  Miss  D.  and  that  the 
latter  had  not  the  slightest  suspicion  of  any  perse- 
cution, she  answered  me  simply: —  "Then  my  last 
doubt  is  gone." 

From  that  date  the  patient  may  be  considered  re- 
covered. A  week  later  when  she  called  upon  me  she 
felt  herself  entirely  free.  She  had  made  a  call  upon 
Miss  D.  and  the  old  friendship  was  just  as  strong  as 
ever  between  them.  Furthermore  she  had  again 
started  taking  dinners  at  a  restaurant  and  her 
friends  there  had  made  a  little  feast  to  welcome  her 
back. 

She  continued  to  visit  me  once  every  week  until  I 
left  town  in  June.  During  this  time  she  renewed  old 
connections  more  and  more  freely.  It  had  become  a 
delight  to  her  to  walk  through  the  streets,  to  visit 
shops,  etc.,  without  the  slightest  feeling  of  uneasi- 
ness. She  was  overjoyed  to  stand  once  more  in  nat- 
ural rapport  with  life.  Of  her  past  illness  she  spoke 
with  entire  objectivity.  Once,  for  example,  she 
asked  my  opinion  as  to  whether  she  had  had  hallu- 
cinations or  not.  She  believed  that  the  movements  of 
the  tongue  sometimes  were  hallucinations  because 


Extract  from  a  Case-History  295 

they  had  been  made  with  such  lightning  speed.  Genu- 
ine movements  scarcely  could  be  made  so  rapidly. 
Very  likely  the  scraping  with  the  feet  too  had  been 
hallucinatory.  I  told  her  that  in  my  opinion  she 
had  reached  the  right  conclusion  in  this  matter. 

When  the  summer  was  over  the  patient  again  came 
to  see  me.  She  had  spent  her  vacation  with  a  friend 
at  the  seaside,  and  had  had  great  pleasure  out  of 
it.  She  had  there  made  many  pleasant  acquaint- 
ances with  whom  she  had  daily  association.  The 
old  thoughts  had  never  returned.  She  said  very 
calmly :  ".  .  .  It  was  an  illness.  Now  it  is  over." 

During  the  past  year  the  patient  has  visited  me 
perhaps  a  dozen  times.  We  have  talked  together 
about  literature  and  the  various  events  of  the  day. 
Occasionally  I  have  made  use  of  my  opportunity  to 
inquire  into  details  concerning  her  past  life.  I  never 
have  been  able  to  discover  the  slightest  trace  of  either 
relapse  or  mental  weakness.  She  has  worked  with 
full  forces  and  she  has  lost  no  opportunity  to  enjoy 
whatever  pleasure  came  in  her  way. 

Several  times  she  has  expressed  a  wish  that  I 
make  her  case-history  public.  "Perhaps,"  she  has 
said,  "it  might  help  someone  else  and  then  I  should 
not  have  gone  through  my  fearful  suffering  to  no 
purpose."  When  I  determined  to  do  this  I  told  her 
and  she  was  greatly  gratified. 

I  had,  after  the  treatment  came  to  a  conclusion, 
made  the  acquaintance  of  the  patient's  niece  of  whom 


296      History  and  Practice  of  Psychanalytis 

I  have  already  had  occasion  to  speak, — a  very  intel- 
ligent and  highly  educated  woman.  She  knew  with 
certainty  that  the  love-affair  of  the  patient  in 
X-Burg  was  no  imaginary  experience  but  something 
which  she  really  had  lived  through.  She  (the  niece) 
had  known  the  man  concerned.  Through  this  niece 
I  was  able  to  verify  statements  of  the  patient  con- 
cerning her  family,  etc.  During  the  whole  course 
of  the  treatment  the  niece  had  met  daily  with  the 
patient  and  discussed  the  new  points  of  view  with 
her.  There  is  no  doubt,  that  in  this  niece  I  had  a 
valuable  ally. 

We  still  have  the  question  to  consider  as  to 
whether  other  circumstances  than  those  solely  con- 
nected with  my  treatment,  had  influence  upon  the 
patient.  The  one  change  in  her  external  life  dur- 
ing this  time,  was  the  death  of  her  father.  To  all 
appearances  this  event  had  passed  with  her  as  any 
indifferent  occurrence  might  have  done.  She  came 
the  same  day,  as  usual,  to  me  for  her  treatment,  nor 
should  I  have  suspected  that  anything  had  happened 
if  she  had  not  been  dressed  in  mourning.  The  man 
was  very  old  and  ill  and,  like  the  rest  of  the  family, 
the  patient  looked  upon  his  death  as  a  kind  of  relief. 
I  am  convinced  that  this  occurrence  had  not  even 
an  unconscious  effect  upon  the  state  of  her  mind. 
I  am  furthermore  convinced  that  no  conditions  un- 
known to  me  had  had  influence  upon  her.  The  niece, 
who  was  conversant  with  all  details  in  the  life  of  the 


Extract  from  a  Case-History  297 

patient,  surely  would  not  have  remained  in  ignorance 
if  any  such  conditions  had  existed,  nor  in  her  sym- 
pathetic assistance  with  my  work  in  the  case,  would 
she  have  failed  to  report  any  contingent  circum- 
stances to  me. 


vni 

POINTS  OF  VIEW  AND  OUTLOOKS 

IT  is  difficult  to  obtain  a  clear  outlook  over  the 
possibilities  of  psychotherapy  through  a  fragmen- 
tary presentation  of  some  of  its  issues  and  lines  of 
thought.  Even  if  we  should  go  through  in  detail 
everything  which,  during  the  past  century  can  pos- 
sibly be  looked  upon  as  falling  within  this  sphere, 
and  if  we  should  pause  at  each  one  who  has  had  any- 
thing to  do  with  it,  we  should  not  even  then  be  able 
fully  to  comprehend  what  it  now  means.  And  still 
less  should  we  be  able  to  construct  for  ourselves  a 
clear  idea  of  the  present  status  of  psychotherapy 
and  of  the  purpose  toward  which  it  most  deeply  aims. 
It  is  necessary  to  see  it  all  in  wider  historical  connec- 
tions. 

In  its  earliest  state  the  healing  art  was  inextric- 
ably mixed  up  with  religion.  The  priest  was  also  the 
medicine  man.  Zarathustra's  holy  books  contain 
very  many  rules  concerning  ablutions,  etc. ;  things 
which  in  these  days  would  come  under  the  head  of 
hygiene.  In  the  Greek  temple  of  Asclepius,  the 
gods  enlightened  those  who  slept  within,  as  to  how 

298 


Points  of  View  and  Outlooks  299 

they  might  free  themselves  from  disease.  Thus  in 
the  earliest  state  of  culture  there  arose  a  struggle 
within  mankind  to  guard  itself  against  unseen  ene- 
mies by  whom  it  felt  itself  to  be  surrounded ;  to  these 
enemies  disease  belonged, — it  was  as  dim  and  intan- 
gible as  the  rest.  This  struggle  was  an  aimless  one, 
a  grasping  after  anything  at  all  in  which  there 
seemed  to  be,  even  for  the  moment,  an  atom  of  help. 
Out  of  this  guarded  primitive-culture  the  art  of  heal- 
ing was  differentiated  as  a  decided,  limited  factor  in 
human  life.  This  came  about  through  observation, 
the  fixing  of  cause  and  effect  and  the  contrivance 
of  means,  the  value  of  which  could  with  surety  be 
verified.  It  became  the  task  of  this  new  function  to 
conquer,  on  the  sure  road  of  experience,  one  field 
after  another.  The  history  of  medicine  simply 
shows  how  research,  century  after  century,  has  taken 
hold  of  the  phenomena  of  disease,  which  at  an  earlier 
period  had  been  thought  to  originate  from  the  inter- 
ference of  unknown  gods.  Primitive  culture  has  con- 
stantly tried  to  keep  this  development  down.  Even 
now  the  disentanglement  of  medicine  from  religion 
meets  with  opposition.  How  tenacious  this  is,  is 
shown  for  instance,  in  the  annals  of  Lourdes.  And 
how  deeply  rooted  the  association  is  in  the  human 
consciousness,  may  be  understood  from  the  enor- 
mous following  which  such  a  movement  as  Christian 
Science  can  win,  even  among  those  who  believe  them- 
selves educated. 


300      History  and  Practice  of  Psychanalysis 

The  psychic-life  is  generally  the  sphere  wherein 
the  application  of  causal  laws  meets  with  greatest 
difficulties.  When  the  thought  first  came  up  that 
each  observable  phenomenon  in  the  external  world 
is  a  decided  consequence  of  a  decided  act,  it  met  with 
unprecedented  opposition.  Gradually  we  became 
used  to  this  way  of  representation.  The  idea  that 
the  same  thing  holds  good  in  the  observable  phe- 
nomena of  the  psychic  life,  continues  to  be  strange 
to  many.  And  this  more  especially  in  questions  of 
morbid  conditions.  Anxiety  comes  upon  a  person 
without  knowledge  as  to  whence  it  came  and  the  vic- 
tim calms  himself  with  the  thought  that  lies  nearest 
at  hand,  viz:  "This  lias  no  special  cause."  If  we 
discover  something  in  the  world  about  us  that  we 
do  not  understand  we  presume  at  once  that  after 
closer  examination  we  may  be  able  to  deduce  a  reason 
for  it  out  of  given  laws.  But  if  we  discover  in  a 
similar  way  something  unfamiliar  within  ourselves, 
we  much  too  easily  accept  the  feeling  that  we  are 
the  prey  of  forces  which  are  not  to  be  reached.  It 
is  hard  to  see  the  connection  between  cause  and  effect 
in  the  sphere  of  the  unsound  mental  life ;  but  it  must 
be  allowed  that  we  are  victims  to  gross  illusion  when, 
powerless  before  this  difficulty,  we  decide  that  no 
connection  exists, — or  that  in  every  case,  it  is  incap- 
able of  being  unraveled. 

All  this  means  that  the  disentanglement  of  psycho 


Points  of  View  and  Outlooks  301 

therapy  from  primitive  culture  has  not  kept  abreast 
of  the  rest  of  medicine.  In  this  field  people  still 
surrender  themselves  to  chance,  time,  contingencies, 
— whatever  they  call  that  which  they  believe  they 
are  unable  to  grasp, — just  as  a  thousand  years  ago 
they  resigned  themselves  to  the  devastation  of  epi- 
demics. Or  else  they  seek  help  in  every  conceivable 
direction,  whether  it  has  connection  with  the  genuine 
cause  of  suffering  or  not,  simply  because  "something 
must  be  done."  It  would  be  an  interesting  task  to 
show  how  primitive  man's  way  of  apprehending  the 
world,  still  lives  in  this  sphere  of  consciousness, 
stretched  out  to  an  extent  concerning  which  no  one 
may  be  able  to  obtain  a  clear  idea.  Who,  for  in- 
stance, reckons,  in  the  critical  examination  of  his 
feelings,  with  the  periodicity  of  the  psychic-life,  in 
precisely  the  same  way  we  reckon  with  that  perio- 
dicity in  the  external  world,  which  reveals  itself  in  the 
change  between  day  and  night,  summer  and  winter; 
—and  yet  the  former  is  no  less  obvious  than  the  lat- 
ter. In  an  old  romance  of  the  north  country  it  is 
related  how  the  people,  when  the  sun  in  the  autumn 
showed  itself  each  day  less  and  less,  were  seized  with 
terrible  fear  lest  it  should  never  again  return,  and 
how  this  fear  continued  during  the  whole  of  the  dark 
period.  We  have  acquired  an  undisturbed  trust  in 
the  conformity  to  law  of  external  forces;  but  how 
very  far  we  really  are  from  similar  confidence  in  that 


302      History  and  Practice  of  Psychanalysis 

which  takes  place  within  ourselves.  And  when  shall 
we  come  so  far  that  we  not  only  shall  understand, 
but  also  be  able  to  subordinate  the  forces  of  the  inner 
life, — in  a  way  similar  to  that  in  which  we  now  work 
to  make  the  utmost  use  of  nature's  forces  in  our 
service  ?  I  have  several  times  in  the  foregoing  studies 
called  attention  to  the  fact  that  the  chief  aim  of 
psychotherapy  is  often  the  re-valuing,  through  which 
something  which  formerly  was  destructive  becomes  a 
means  for  advancement.  But  this  goal  seems  very 
distant  when  not  even  the  slightest  presumption  that 
we  shall  be  able  to  aspire  to  it, — the  feeling  of  all 
things  being  established  by  law,  is  common  property. 
One  ought  to  be  able  to  show  in  every  single  re- 
spect how  psychotherapy's  disentanglement  as  an  in- 
dependent factor  in  human  life,  is  hindered  by  primi- 
tive conceptions  and  by  the  preservation  of  these 
conceptions  by  institutions  which  long  since  have 
outlived  their  usefulness.  Much  which  rightfully 
falls  within  the  field  of  a  purposeful  psychotherapy 
and  ought  to  have  been  relegated  to  that  field,  is  still 
associated  in  the  most  perplexing  and  indefinite  way, 
with  religious  ideas.  Possibly  it  may  yet  require  cen- 
turies to  dissolve  every  bit  of  this  residue  of  the  past. 
It  is  not  necessary  to  examine  the  question  here ;  but 
if  one  wishes  to  understand  psychotherapy's  struggle 
for  freedom  out  of  bondage,  one  must  look  at  it  in 
connection  with  the  difficulties  which  medicine  in 


Points  of  View  and  Outlooks  303 

general  has  had  to  overcome,  in  order  to  arrive  at  its 
present  status. 


If  psychotherapy  is  to  succeed  in  constituting 
itself  as  a  necessary  part  of  the  life-culture  it  means 
first  of  all  that  all  efforts  which  revolve  about  it  be 
gathered  together,  humanized,  and  developed.  The 
inner  process  of  education  is  more  important  than 
the  fight  against  external  conditions,  no  matter  how 
old  may  be  the  prejudices  upon  which  this  fight  may 
be  founded. 

Instead  of  tearing  the  movement  to  shreds  in  dis- 
cussion of  theoretical  details,  its  representatives 
must  above  all  have  great  unity  of  purpose  in  view, 
before  which  all  incidental  differences  of  meaning  be- 
come relatively  unimportant.  A  great  work  must  be 
attacked  from  different  sides;  every  personal 
thought-force  represents  one  such  side.  When  the 
same  necessity  lies  at  the  bottom  of  all  attacks,  the 
work  by  itself,  during  its  growth  reaches  a  certain 
unification. 

I  have  tried  to  show  how  psychotherapy  has  taken 
on  peculiar  differences  in  the  hands  of  different 
teachers.  Now  one,  now  another  foundation  for  it 
lias  been  tried,  and  adjustment  of  the  treatment 
toward  one  or  another  purpose  has  been  striven  after. 


304      History  and  Practice  of  Psychanalysis 

In  spite  of  this  there  is  no  difficulty  in  demonstrat- 
ing the  unity  which  is  behind  all  this  apparent  dis- 
sension. Ideas  emanating  from  different  sources 
are  like  different  threads  upon  which  the  growth  is 
spun  out  to  greater  lengths; — and  all  threads  run 
together  to  a  warp  where  the  fabric  finally  appears 
in  bold  relief,  picturing  life  itself  with  all  its  depths 
and  all  its  variations  between  light  and  shade.  The 
warp  is  in  danger  as  soon  as  some  one  endeavors  to 
make  one  thread  or  the  other  the  only  one  essen- 
tial ; — and  this  the  more  if  at  the  same  time  one  tries 
to  cut  the  other  threads  in  hope  of  being  able  to  dem- 
onstrate their  superfluity.  Sadly  enough  one  can 
not  exonerate  any  single  one  among  the  leaders  in 
this  line  of  thought  from  having  made  an  effort  in 
this  direction.  But  happily  on  the  other  hand,  one 
begins  to  see  the  unsuitability  of  all  such  attempts. 
Especially  from  one  direction  there  is  at  work  an 
earnest  effort  to  free  the  movement  from  all  one- 
sided tendencies  and  to  lift  it  up  in  its  entirety,  to  a 
higher  plane. 


One  of  these  threads  of  development,  I  have  tried 
in  the  foregoing  pages  to  deduce  from  Feuchters- 
leben.  For  him  the  chief  characteristic  was  the  em- 
phasizing of  the  importance  of  common-sense  for 
the  preservation  of  health.  His  dream  was  of  some 


Points  of  View  and  Outlooks  305 

doctrine  of  wisdom  which  would  be  so  wholly  in  har- 
mony with  nature's  own  arrangements  that  he  who 
let  himself  be  led  by  her  would  be  able  to  take  care 
of  his  inner  equilibrium,  no  matter  how  strong  were 
the  storms  of  life  which  might  try  to  shake  it.  That 
this  dream  could  not  be  realized  is  chiefly  because 
most  of  that  which  threatens  the  harmony  of  the 
psychic-life,  does  not  lie  as  a  rule  within  the  sphere 
of  consciousness,  and  therefore  is  not  accessible  to 
the  working  out  of  the  laws  of  common-sense.  But 
despite  all  limitations,  this  rationalistic  trend  will 
always  keep  its  value.  Today  in  its  most  pro- 
nounced form  it  is  supported  by  Dubois  and  is  a 
somewhat  milder  way  by  Dejerine. 

A  great  mass  of  suffering  has  its  root  in  misap- 
prehensions, exaggerated  suspicions,  stirred-up  de- 
mands which  can  not  be  satisfied.  Many  people  sus- 
pect an  incurable  trouble  in  every  pain,  or  judge 
themselves  in  the  severest  way  for  each  thought  that 
arises  in  opposition  to  their  longing  for  purity.  It 
falls  within  the  activity  of  the  doctor  to  bring  such 
confusion  to  rights  by  throwing  light  upon  it;  he 
does  not  bear  the  name  doctor, — teacher,  for  noth- 
ing. It  may  often  happen  that  a  valetudinarian  feels 
himself  freed,  after  a  single  investigation  into  his 
inner  life,  from  some  burden  he  has  carried  on  his 
back  for  years.  But  oftener  it  happens  that  the  pa- 
tient has  tangled  himself  into  such  confusion,  and 
that  erroneous  ideas  have  become  so  fixed  into  his 


806     History  and  Practice  of  Psychanalysis 

mind,  that  deliverance  from  them  can  be  attained 
only  after  exhaustive  analysis.  Under  such  circum- 
stances it  is  by  no  means  enough  to  say  "Such  and 
such  is  so."  One  must  be  able  by  means  of  numerous 
analogies  to  demonstrate  that  it  is  so;  one  must  be 
able  to  convince  the  patient  of  the  right  of  these 
causal-connections,  which  at  first  glance  appear  to 
be  unfounded.  In  order  to  do  this,  not  only  the  knowl- 
edge of  the  neurologist  concerning  nervous  disturb- 
ances is  necessary,but  also  the  insight  of  the  psychol- 
ogist, as  to  those  ways  in  which  the  patient  has 
come  to  accept  something  unreal  in  the  place  of 
reality.  Without  a  deepened  power  for  acute  ob- 
servation of  all  that  which  in  co-operation,  has  built 
up  the  psychic  turmoil,  the  rationalistic  movement 
dissolves  into  empty  dialectic.  It  is  greatly  to  be 
deplored  that  Dubois  instead  of  appropriating 
psychanalysis  and  using  it,  has  tried  to  support  "his 
method's"  superiority  against  it. 

And  it  is  much  to  be  regretted  that  Feuchtersleben 
has  no  disciples  in  these  days  who  would  seek  to  ap- 
ply modern  human  wisdom  to  psychotherapy.  The 
one  who  perhaps  comes  nearest  to  this,  Marcinowski, 
follows  far  too  one-sidedly  in  Nietzsche's  foot-steps. 
It  is  not  sufficient  to  gather  wisdom  from  the  painful 
experiences  of  one  or  another  thinker;  one  must  try 
to  harken  to  it  directly  from  all  the  lamentations  un- 
der which  the  times  are  groaning. 

Everyone  has  certain  directing  lines  for  his  way 


Pomts  of  View  and  Outlooks  307 

of  thinking  and  acting.  If  one  wishes  by  way  of 
rational  persuasion  to  bring  about  a  favorable 
change  where  nervous  disturbances  are  concerned, 
one  must  also  let  himself  be  led  by  certain  principles. 
Whence  shall  we  then  produce  them?  From  those 
most  generally  applied?  It  will  not  be  denied  that 
there  are  truths  which  constantly  hold  a  certain 
value;  but  there  is  nothing  which  under  all  circum- 
stances has  an  equal  value.  By  far  the  plainest  of 
these  truths  seems  to  be  that  the  same  thing  which 
under  certain  conditions  may  lead  one  person  to  sick- 
ness, under  different  conditions  may  lead  another  to 
health.  There  is  nothing  more  risky  than  to  hold 
fast  to  any  decided  principle  according  to  which  an 
effort  is  made  to  influence  all.  The  psychotherapist 
in  front  of  each  individual  case  must  be  willing  to 
give  up  himself  as  well  as  anything  else  which  he 
highly  values ;  he  must  with  entire  plasticity,  seek  to 
adapt  himself  to  the  special  exigencies  of  the  case. 
The  line  of  direction  for  his  persuasion  he  must  fetch 
out  of  the  patient's  own  psychic-life  in  the  given  sit- 
uation; it  means  to  abstract  from  the  condition, 
those  truths  which  have  the  highest  value  just  for 
him  in  just  that  moment.  I  have  already  called  at- 
tention to  this  in  another  connection;  but  too  much 
stress  cannot  be  laid  upon  this  point.  Nothing  can 
be  more  against  the  spirit  of  psychotherapy  than  an 
effort  to  force  the  mind  into  a  ready-made  thought- 
system,  which  may  have  either  religious  or  scientific 


308      History  and  Practice  of  Psychanalysis 

imprint.  For  all  such  attempts  counteract  the  true 
fundamental  conditions  for  real  psychic  health — 
namely  individual  liberation  and  the  preservation  of 
inner  plasticity.  If  one  is  fettered  by  mass-instincts, 
petrified  in  thoughts  that  do  not  arise  from  one's 
own  inner  life,  even  if  apparently  one  seems  to  con- 
tinue mentally  sound,  it  is  by  no  means  sure  that 
one's  state  is  such  that  it  ought  to  be  preferred  to  a 
turbulent  struggle  with  reality. 

From  the  psychanalytical  view-point  all  manner  of 
objections  are  made  against  treatment  by  persua- 
sion. One  reasons  about  it  after  this  manner:  life  is 
as  a  rule  not  built  up  in  a  logical  way — it  is  our  feel- 
ings and  impulses  that  determine  all  things — the 
thoughts  are  only  a  superficial  temporary  remodel- 
ing of  those  forces,  a  secondary  "rationalization"  of 
their  content.  All  the  opinions  of  a  person  are  con- 
structed in  this  manner  in  roundabout  ways,  out  of 
the  most  profound  earthly  forces;  against  these, 
logical  persuasion  carries  no  weight.  As  a  matter 
of  fact,  no  one  lets  himself  be  talked  over  to  any- 
thing and  every  attempt  to  aid  a  sufferer  in  this  way 
is  vain.  More  plainly  than  this,  spiritual  loneliness 
cannot  be  pointed  out.  It  will  be  hard  to  find  a  line 
of  thought  which  excels  the  Freud  dogmatism  in 
making  life  isolated. 

Nevertheless  in  the  persuasion  method  there  is  a 
certain  degree  of  truth. 

It  is  true  that  nothing  can  be  lastingly  inserted 


Pomtg  of  View  and  Outlooks  309 

into  a  mind  by  means  of  persuasion,  which  is  strange 
to  that  mind.  But  persuasion  may  be  a  forceful 
aid  in  actualizing  something  vital  which  has  sunk 
down  out  of  sight  and  withered  away.  It  is  perhaps 
true  that  life  and  the  activity  to  which  we  are  des- 
tined, far  from  carrying  on  our  inner  accretion  of 
power,  often — or  most  often — is  of  the  greatest 
danger  to  it.  Social  demands  trample  unscrupu- 
lously upon  that  to  which  we  aspire  in  our  longing 
toward  freedom;  they  seek  to  bring  the  very  desires 
of  our  hearts  to  silence.  When  this  goes  on  year 
after  year  our  natures  draw  back  into  themselves 
distracted;  more  and  more  the  feeling  of  what  one 
is  and  what  one  wishes,  is  lost.  It  is  the  psych- 
analyst's  duty  to  call  forth  these  voices  of  the  deep, 
which  have  so  continually  been  silenced  that  the 
patient  no  longer  hears  them  himself.  If  he  is  suc- 
cessful in  doing  this  and  if  he  gets  the  proper  grip 
on  the  personality  of  the  patient,  then  he  may  often 
need  the  whole  logical  strength  of  persuasion  to  con- 
vince that  patient  that  he  is  what  he  is.  The  real  self 
has  disappeared  so  entirely  in  this  leveling  struggle, 
that  at  first  the  patient  does  not  recognize  it  when 
it  again  stands  before  his  eyes; — the  analyst  must 
point  out  now  one,  now  the  other  feature  in  order 
to  convince  him  that  it  really  belongs  to  that  self. 
It  is  true  that  every  person  is  a  being  in  himself  and 
that  each  of  us  in  his  inmost  nature  is  alone.  But 
one  of  the  greatest  values  of  life  lies  in  this  fact, — 


310      History  and  Practice  of  Psychanalysia 

for  if  it  were  not  true  we  should  never  be  able  to 
discover  each  other.  And  in  the  joy  of  this  dis- 
covery the  oppression  of  loneliness  disappears. 

I  said  the  foremost  representative  of  the  rational- 
istic method  of  treatment,  Dubois,  turned  against  the 
modern  trend  of  thought  which  is  summed  up  under 
the  name,  psychanalysis.  This,  however,  has  not 
prevented  its  development.  It  more  nearly  signified 
that  he  and  his  followers  turned  against  treatment 
by  suggestion.  In  childish  self-vindication  he  has 
set  up  his  "persuasion"  idea  in  opposition  to  the  old 
idea  of  suggestion.  This  has  produced,  in  connec- 
tion therewith,  treatises  by  the  hundred,  where,  in 
scholastic  dialectic,  attempts  have  been  made  to  draw 
boundaries  between  these  two  ideas  in  order  to  then 
give  either  one  or  the  other  the  preference ; — the  re- 
sult has  been  confusion. 

In  the  foregoing  pages  I  defined  suggestion  as  an 
idea  which  is  carried  into  effect  in  the  organism  in 
a  unique  way ;  it  implies  transition  from  imagination 
to  reality.  As  I  have  just  said,  by  means  of  per- 
suasion something  which  has  lost  its  reality  value 
may  once  more  regain  it.  There  is  thus  a  kind  of 
inner  affinity  between  the  two  processes.  This  never- 
theless, does  not  prevent  one  from  theoretically  sepa- 
rating them;  the  homogeneous  changes  may  come 
about  in  different  ways.  However,  this  separation 
has  very  little  of  interest.  For  in  practice  the  bound- 
ary lines  run  together.  In  practice  there  is  no  ques- 


Points  of  View  and  Outlooks  311 

tion  of  a  theoretical  preference  over  the  one  or  the 
other;  there  one  makes  use  of  that  which  is  most 
suitable  to  the  occasion. 

A  little  episode  occurs  to  me  which  made  the  na- 
ture of  suggestion  suddenly  stand  out  clear  before 
me. 

Once  many  years  ago,  I  was  out  on  a  tramp  in 
the  mountains  and  started  early  one  morning  to 
ascend  a  peak.  I  had  been  up  before  and  knew  the 
ascent  was  not  dangerous.  I  had  a  guide  with  whom 
I  had  had  long  acquaintance  and  upon  whom  I  could 
rely  implicitly.  But  somehow  when  I  neared  the  top 
I  became  frightened.  The  chasms  below  yawned  ter- 
rifyingly  and  the  ice-slopes  above  were  steep; — I 
stopped  and  gazed  down  at  the  sharp  rocks  among 
which  I  should  land  in  case  I  lost  my  footing.  I 
grew  dizzy  and  the  distance  between  me  and  my  guide 
seemed  to  grow.  At  last  I  shouted  to  him  that  he 
must  chop  better  steps  in  the  ice.  He  turned  around, 
he  must  have  noticed  something  unsteady  in  my 
voice ;  for  he  answered  at  once :  "No  need  of  that ! 
There  isn't  a  trace  of  danger."  And  so  he  went 
on. —  I  can  still  recall  how  all  apprehension  dis- 
appeared at  once  as  if  by  magic.  I  laughed  at  the 
feeling  I  had  had.  I  looked  down  and  up  with  the 
same  composure  I  would  have  felt  in  walking  the 
levelest  and  most  familiar  road.  The  words  of  the 
guide  had  meant  something  quite  other  than  the  ex- 
pression of  a  fact,  the  communication  of  an  idea; 


812      History  and  Practice  of  Psychanalysis 

they  had  meant  an  inner  change  of  the  most  obvious 
sort. 

The  first  and  most  momentous  reason  for  the  pos- 
sibility of  this  occurrence  lies  in  the  fact  that  I  had 
become  confused  and  that  the  words  brought  me 
back  to  reality.  They  actualized,  to  put  it  in  an- 
other way,  something  that  was  within  me,  but  which 
for  the  moment  was  obscured  by  delusive  feelings  and 
erroneous  representations.  Had  a  real  danger  exist- 
ed, the  words  would  have  meant  nothing  to  me.  The 
other  reason  lay  in  my  confidence  in  the  guide.  I 
knew  him  well  enough  to  be  positive  that  he  never 
would  say  anything  that  he  himself  was  not  sure  of. 
This  may  seem  like  credulity.  But  I  knew  that  if  it 
had  been  necessary,  he  would,  by  means  of  examples 
of  similar  cases — by  pointing  out  the  angles  of  the 
ice-slopes,  the  softness  of  the  ice,  etc., — have  been 
able  to  demonstrate  the  truthfulness  of  his  assertion. 
Back  of  this  is  really  hidden  all  the  logical  apparatus 
of  persuasion. 

Something  like  it  continually  happens  in  the  rela- 
tion between  doctor  and  patient.  What  else  is  the 
invalid  but  a  poor  seeking  wanderer  in  the  desolate 
places  of  life.  Things  swim  before  his  eyes,  every- 
thing looks  terrible  and  hard  to  climb — he  is  unable 
to  calmly  pilot  himself  between  the  yawning  abysses 
of  his  conflicts.  If  the  physician  says:  "Here  is 
your  way!" — he  must  also  be  able  to  prove  that  it 
is  so.  And  if  he  can  do  that  then  the  use  of  many 


Points  of  View  and  Outlooks  313 

words  would  be  superfluous.  It  is  not  necessary  to 
enter  upon  the  question  of  the  mystery  of  silence  in 
order  to  show  how  a  single  hearty  grasp  of  the  hand 
may  sometimes  hold  more  meaning  than  the  most 
eloquent  explanation.  And  suggestion  is  simply  that 
spiritual  grasp  of  the  hand  that  directly  carries 
things  once  more  to  their  right  place. 

Understanding  of  this  is  important  because  it  is 
with  this  setting  aside  of  obscure  complications  in 
the  feeling-  and  thought-life,  that  one  especially  has 
to  do.  The  prevailing  idea  of  treatment  by  sugges- 
tion has  been  that  it  simply  means  the  implanting 
of  health-bringing  thoughts ; — it  much  of tener  im- 
plies the  breaking  down  and  dissolving  of  auto-sug- 
gestions which  stand  in  the  way  of  recovery.  We 
become  ill  chiefly  because  of  experiences  filled  with 
fear,  around  which  there  assemble  hopeless  thoughts 
and  fantasies,  that  outline  the  whole  of  existence  as 
a  single  horror, — until  they  become  a  barrier  which 
the  current  of  life  does  not  succeed  in  breaking 
through  when  it  tries  to  reach  us.  In  such  spheres 
are  built  up  those  false  syntheses  which  hold  us 
bound  and  which  decide  what  takes  place  in  our  inner 
lives. 

It  seems  to  me  far  beyond  all  doubt  that  treat- 
ment by  suggestion  is  constructed  upon  such  a  true 
foundation,  that  it  deserves  a  broader  place  in  thera- 
peutics than  it  now  holds.  But  it  must  most  assured- 
ly not  be  carelessly  handled  nor  allowed  to  sink  into 


314      History  and  Practice  of  Psychanalysis 

mere  routine  mold.     It  can  and  must  be  made  of 
deeper  import. 


I  said  that  it  is  unnecessary  to  ponder  over  the 
mystery  of  silence  in  order  to  understand  sugges- 
tion;— but  the  same  thing  can  scarcely  be  said  re- 
garding treatment  by  hypnosis.  In  the  latter  case 
the  effort  is  made  to  arrive  at  an  inner  quietude  in 
which  not  only  the  use  of  many  words  becomes  super- 
fluous, but  which  at  the  same  time,  means  immediate 
disentanglement  from  everything  that  tears  every- 
day life  to  pieces.  What  hinders  self-healing  of  the 
wound  is  often  simply  lack  of  stillness, — lack  of 
ability  to  silence  the  voices  within  us.  Just  as  by 
means  of  suggestion  one  tries  to  actualize  the  essen- 
tial qualities  in  a  person  and  give  to  these  qualities 
power  to  carry  the  burden,  so  in  hypnosis  one  tries 
to  bring  the  patient  into  a  condition  where  every- 
thing that  interferes  with  silence  is  eliminated.  Both 
therapeutic  factors  in  the  literature  concerning  them, 
have  customarily  been  considered  together,  even  to 
such  an  extent  that  the  two  terms  have  been  used 
as  synonymous.  They  have  an  inner  connection,  but 
scarcely  of  the  kind  generally  imagined.  Hypnotism 
is  at  the  same  time  both  simpler  and  more  full  of 
mystery.  We  all  know  how  we  are  more  susceptible 
to  that  which  reaches  us  from  without,  the  more 


Points  of  View  and  Outlooks  315 

indeed,  as  we  let  the  thoughts  have  free  rein  and 
abandon  ourselves  to  them.  We  do  not  catch  the 
deeper  import  of  what  some  one  says,  if  we  brace 
ourselves  to  meet  it  with  our  own  counter  arguments ; 
we  do  not  feel  all  the  sentiment  which  rests  over  na- 
ture if  our  attention  remains  bound  up  in  some 
problem  which  occupied  us  before  we  went  out  of 
doors.  The  added  susceptibility — the  suggestibility 
— in  hypnosis  is  nothing  but  a  consequence  of  the 
intentional  unfastening  of  the  trend  of  thought. 
And  it  thus  has  far-reaching  association  with  the 
commonest  every  day  circumstances.  But  when  this 
simple  process  reaches  a  certain  point  it  is  as  if 
the  whole  tension  into  which  the  daily  life  has  knit 
itself  together,  and  in  which  we  are  compulsorily  fet- 
tered, relaxed.  It  is  as  if  the  soul-life  at  the  same 
time  gained  additional,  more  graduated  plasticity,  a 
freedom,  due  to  which  things  may  be  carried  into  ef- 
fect in  our  inner  lives,  which  under  ordinary  cir- 
cumstances would  remain  objects  to  be  wished  for  in 
vain.  It  is  after  an  expression  for  this,  that  one 
seeks  when  one  talks  about  suggestibility  in  its 
deeper  meaning ;  here  one  touches  something  that  has 
to  do  with  the  mystery  of  life  itself.  And  that 
one  stands  sometimes  in  the  practical  demonstration 
of  this  circumstance,  before  phenomena  which  work 
wonders,  can  scarcely  be  a  subject  for  denial.  Those 
quick  cures  of  which  we  read  in  the  literature  of  the 
decade  from  1880-1890,  were  not  products  of  the 


316      History  and  Practice  of  Psychanalysis 

mind,  but  realities.  I  have  myself  many  times  seen 
such  curative  action,  which  unless  I  had  seen  it,  I 
should  have  had  hard  work  to  credit.  But  unfortu- 
nately such  things  are  not  to  be  counted  on.  The 
modern  physician  holds  decided  opposition  to  every- 
thing he  cannot  bring  into  full  and  tangible  connec- 
tion with  the  rest  of  knowledge.  He  prefers  to  let 
one  factor  lie  untouched  until  its  claim  for  clear 
explanation  is  satisfied,  rather  than  to  reckon  with 
it  in  any  wavering  uncertain  form.  Hitherto  there 
has  been  insuperable  difficulty  in  amalgamating  hyp- 
nosis with  the  rest  of  science;  how  an  effort  I  have 
made  in  this  direction  will  come  out  is  still  uncer- 
tain. For  myself,  however,  it  means  a  solution  of 
the  problem. 


In  cures  in  the  hypnotic  condition  many  different 
factors  undoubtedly  play  a  part.  That  these  fac- 
tors may  be  separated  and  demonstrated  each  one 
by  itself,  seems  to  me  probable;  it  should  in  other 
words  signify  a  deliberate  development  ef  hypnotic 
therapy  along  different  lines. 

As  an  example  of  what  I  mean  I  may  here  men- 
tion Frank's  way  of  getting  at  hypnosis.  It  is  allied 
most  closely  to  the  first  stadium  of  psychanalyses. 
It  was  applied  then  to  the  effort  to  "abreact"  those 
affects  which  had  been  pushed  aside  into  the  uncon- 


Points  of  View  and  Outlooks  317 

scious  mind.  In  this  way  one  made  an  endeavor  to 
bring  them  again  to  life,  to  reproduce  them  in  the 
consciousness.  As  I  showed  when  speaking  of  this 
before,  we  have  come,  because  of  reasons  which, 
viewed  on  a  large  scale  must  be  considered  valid, 
away  from  this  road.  Psychanalysts  satisfy  them- 
selves now  in  general,  with  the  working  out  of  the  re- 
pressed idea-material  itself  and  with  the  explanation 
of  this  material; — it  is  on  this  last  point  that  the 
chief  importance  now  lies. 

But  the  original  standpoint  hides  a  kernel  of  truth 
which  entitles  it  to  preservation. 

The  continuity  in  the  chain  of  different  experi- 
ences is  first  brought  about  through  the  inner  con- 
nection of  the  feelings.  There  was  a  deep  folk- 
hygienic  wisdom  in  the  old  rule  which  compelled  every 
one  to  go  to  mass  each  morning.  There  people  were 
calmed  into  the  same  mood  from  day  to  day,  from 
month  to  month,  from  year  to  year; — it  was  like 
a  continuous  living  stream  of  feeling  that  bore  them, 
one  might  almost  say,  from  the  cradle  to  the  grave. 
If  there  came  then  inner  storms  of  the  most  lacerat- 
ing kind,  this  foundation-current  of  the  feelings  nev- 
ertheless always  represented  a  certain  connection. 
The  modern  man  stripped  of  all  such  assistance  finds 
himself  in  a  situation  which  leaves  possibilities  open 
for  inharmonious  disorganization  reaching  to  the 
very  bottom  of  his  nature.  Every  time  a  person  is 
carried  away  by  a  new  emotion,  the  same  thing  as  a 


318      History  and  Practice  of  Psychanalysis 

new  "I"  is  built  up  in  his  mind.  And  if  this  discon- 
tinuity is  once  well  constructed,  it  is  hard  to  over- 
come. Life  continually  goes  on — driven  by  the  hope 
that  at  last  one  feeling  shall  force  all  others  into  the 
background  and  dissolve  all  that  has  gone  before  into 
undisturbed  harmony.  But  just  in  that  lack  of  col- 
lectedness  which  the  emotion  implies,  lies  the  great- 
est obstacle  for  hope  thai  this  ever  will  be  accom- 
plished. For  the  qualification  itself  for  a  great  and 
all-devouring  feeling  is  simply  a  certain  inner  cen- 
tralization of  the  emotions — a  possibility  for  all  the 
separate  currents  to  flow  together. 

It  is  right  to  try  to  make  use  of  that  inner  still- 
ness which  is  the  essence  of  hypnosis,  toward  a  gath- 
ering together  of  the  shattered  emotions.  One  shuts 
out  thereby  every  new  thing  which  might  further  dis- 
turb these  emotions ;  this  means  the  isolation  of  the 
individual  within  himself.  It  means  further  that  con- 
centration inward,  which  is  so  characteristic  of  hyp- 
nosis.  If  we  wish  te  bring  out  into  our  conscious- 
ness something  which  has  been  repressed  and  lies 
hidden  behind  strong  opposition,  then  we  direct  the 
attention  toward  that  end;  by  so  doing  first  comes 
out  the  memory-picture  itself,  stripped  of  all  the  sen- 
timents and  affects  with  which  it  originally  was 
bound  up,  and  which  in  it  had  its  symbol.  Only  lit- 
tle by  little  does  all  come  to  life  again — the,picture 
itself  fading  away  before  the  deeper  reality.  When 
in  such  a  way  one  again  lives  through  those  feelings 


Points  of  View  and  Outlooks  319 

which  have  been  most  vital  in  life  as  ineffaceable  real- 
ities in  a  single  connection,  then  is  the  disharmony 
made  loose  from  its  foundation.  I  am  inclined  to 
believe  that  the  strong  effect  Wetterstrand  obtained 
by  means  of  the  prolonged  sleep,  in  a  great  measure 
was  due  to  the  fact  that  during  it  there  set  in  spon- 
taneously some  such  centralizing  of  the  emotions. 
At  least  I  have  found  it  so  at  various  times  when 
I  myself  have  made  use  of  the  same  method. 


In  the  face  of  the  effort  of  psychanalysis  to 
monopolize  psychotherapy,  not  even  the  most  val- 
uable of  the  earlier  suggestions  has  been  able  to  hold 
ground.  Not  only  because  all  the  new  view- 
points it  gives  us,  draw  attention  away  from  what  al- 
ready was  proven;  but  more  because  it  turns  itself 
against  everything  old  and  tries  to  trample  it  under 
foot.  In  the  eyes  of  his  pupils,  Freud  not  only  has 
definitely  solved  the  riddle  of  the  Theban  Sphinx  but 
he  has  also  torn  away  the  veil  from  the  sphinx  that 
stands  staring  over  modern  life,  and  that  has  its  ever- 
lasting representative  in  Hamlet.  And  under  the 
lines  of  direction  Freud  gives  out  for  methods  of 
treatment  all  other  efforts  must  be  subordinated. 

I  said  before  that  the  so-called  rational  therapy, 
the  logical  persuasion,  is  dismissed  as  worthless  by 
Freud  and  his  school.  In  an  earlier  connection  I 


S20      History  and  Practice  of  Psychanalysis 

pointed  out  how  they  maintain  the  emptiness  of 
treatment  by  suggestion,  through  talk  of  the  trans- 
ference of  the  father-complex  upon  the  doctor.  The 
latter  question  is,  however,  more  complicated  than 
they  considered  it.  To  silence  all  talk  about  sug- 
gestion playing  any  part  in  psychanalysis,  Freud 
has  banished  the  world  itself  from  all  the  literature 
inspired  by  him.  For  all  those  psychological  condi- 
tions which  are  brought  to  light  by  means  of  the 
study  of  suggestion,  he  uses  his  own  designations. 
His  fundamental  idea  is  this:  suggestion  is  at  first 
hand  an  affective  phenomenon  signifying  such  things 
as  confidence,  collusion,  sympathy,  etc. —  If  these 
are  not  there,  transferred  representations  cannot  be 
carried  over  in  the  characteristic  way.  It  thus  means 
really  a  transference  of  feelings  with  a  definite  con- 
tent of  ideas.  The  suggestion  is  consequently  noth- 
ing but  a  special  case  of  transference  in  general. 
Therewith  Freud  solves  the  whole  thing  in  one  of  his 
principles.  Because  the  transference  proceeds  from 
our  earliest  emotional  associations,  i.  e.  those  with 
mother  and  father,  it  finally  means  the  transference 
of  corresponding  complexes.  It  is  unnecessary  to 
add  that  these,  like  everything  else  in  the  world- 
progress  has  the  sexual  key-note ;  suggestion  is  thus 
a  sexual  phenomenon. 

By  means  of  such  desperate  forcing  of  everything 
into  an  inelastic  theoretical  impasse  there  is  ef- 
fected, however,  something  quite  different  from  that 


Points  of  View  and  Outlooks  321 

which  was  intended.  Truths  are  not  altered  because 
they  are  given  a  stamp  which  makes  them  apparently 
unreal  or  absurd.  If  they  have  not  in  themselves 
such  strong  holding-power  that  they  survive  this 
procedure,  they  soon  of  themselves  disappear  out  of 
the  reckoning,  t  This  way  of  treating  the  truth-values 
of  the  past,  shows  better  than  anything  else  the  limi- 
tations of  a  view-point.  All  criticisms  coming  from 
without  and  all  inner  scientific  differences,  do  not  so 
much  harm  what  Freud  brought  forth,  as  does  his 
infelicitious  tendency  to  drive  one-sidedness  to  ab- 
surdity. It  is  depressing  to  see  such  a  movement 
work  upon  its  own  annihilation.  For  it  can  never 
be  denied  that  it  was  first  through  the  ideas  which 
came  from  this  direction,  that  psychotherapy  was 
able  to  lift  itself  up  to  importance  and  become  a  gen- 
eral life-factor.  Freud  with  one  stroke  has  given  the 
study  of  the  soul-life  such  breadth  and  such  surety, 
that  we  have  obtained  a  foundation  upon  which  to 
build  for  all  time.  One  may  be  never  so  bitter  against 
him  for  the  blunders  he  has  made — yet  no  one  can 
carry  out  a  single  simple  treatment  without  making 
use  of  some  thing  he  discovered.  It  devolves  upon 
those  who  will  take  the  scientific  inheritance  after 
him  to  see  to  it  that  all  his  daring  ingenious  ideas  are 
followed  out  with  every  conceivable  freedom  from 
prejudice.  Only  then  can  everything  which  now  is 
in  a  state  of  fermentation,  be  worked  out. 

And  yet  not  so  much  skill  is  needed  to  unite  psych- 


322     History  and  Practice  of  Psychanalyns 

analysis  to  what  already  obtained  when  Freud  took 
hold  of  the  subject. 

Concerning  the  psychology  of  suggestion  for  in- 
stance, the  analogy  between  post-hypnotic  sugges- 
tion and  childhood-trauma  has  many  times  been 
pointed  out.  And  this  with  right.  In  post-hypnotic 
suggestion  an  idea,  which  one  induces  into  the  me- 
dium, is  released  into  action  after  a  definite  time, 
or  becomes  apparent  by  means  of  a  transitory  nerv- 
ous disturbance,  as  loss  of  sensation,  paralysis  or 
something  of  the  sort.  Childhood  trauma  is  in  a 
similar  way  a  sphere  of  representations  which  life 
works  into  the  consciousness  in  an  earlier  stadium, 
and  which  after  decades,  breaks  out  in  neuroses,  giv- 
ing definite  forms  to  their  symptoms.  Supposing 
that  suggestion  always  does  contain  an  affective  mo- 
ment— everything  is  far  from  said  that  may  be  said 
concerning  this  process.  If  one  applies  in  this  man- 
ner what  one  has  learned  to  know  about  suggestion 
from  the  psychanalytical  store  of  knowledge,  much 
clearness  of  vision  is  won. 

But  of  yet  greater  import  than  that  these  new 
ideas  have,  without  restraint,  added  themselves  to 
that  which  already  was  astir  within  the  realm  of  psy- 
chotherapeutics,  is  that  they  incorporate,  reorgan- 
ize, cleanse  and  go  deeply  into,  the  psychic  means, 
through  which  people  long  before  this  time  had  tried 
to  find  a  road  to  health.  We  find  again  here  on  a 


Points  of  View  and  Outlooks  323 

new  plane,  suited  to  modern  demands,  many  factors 
which  played  a  great  part  in  intellectual  culture. 

There  is  a  deep-seated  necessity  in  mankind  for 
confiding  in  someone.  We  exist  as  a  rule,  not  as 
isolated  beings,  but  only  in  and  through  each  other 
and  with  a  bond  that  holds  us  all  together.  There 
are  circumstances  under  which  this  necessity  cannot 
be  looked  after  in  the  ordinary  way,  by  means  of 
conversation  between  friend  and  friend.  There  are 
secret  places  so  deeply  hidden,  that  we  cannot  bear 
to  see  again  one  to  whom  we  have  disclosed  them ; — 
there  are  things  that  are  so  holy,  that  never  under 
conditions  common  to  daily  life,  can  we  find  an  hour 
quiet  enough  to  give  us  courage  to  touch  upon  them. 
...  It  is  out  of  such  postulations  that  the  confes- 
sional sprang  forth  as  a  necessary  life-factor.  How- 
ever paradoxical  it  may  seem,  there  are  divers 
circumstances  that  make  it  easier  to  talk  with  an  out- 
sider about  things  most  intimate,  than  with  one  who 
belongs  to  us.  The  latter  can  not  avoid  taking  part 
in  those  painful  emotions  by  which  we  are  tormented, 
in  quite  another  way  than  does  the  former — and  this 
resonance  may  easily  increase  the  pain;  instead  of 
then  becoming  free  ourselves,  we  have  on  the  con- 
trary, dragged  another  down  into  our  own  misery. 
It  requires  something  which  under  every  condition 
can  maintain  its  objectivity — for  what  we  covet  is 
simply  to  get  a  part  of  this  objectivity  and  so  make 
free  our  pain  from  ourselves  as  an  object  by  itself. 


824?     Histori/  and  Practice  of  Psychanalysis 

And  furthermore:  if  we  rely  no  matter  how  little 
upon  someone  dear  to  us,  it  can  then  never  be  said 
that  we  are  relying  upon  our  own  discretion  as  fully 
as  necessary.  This  discretion  must  needs  be  kept 
going  because  of  something  other  than  a  personal 
promise,  something  like  a  public  institution  which 
under  no  circumstances  can  be  disturbed;  this  must 
be  the  priest's  or  the  physician's  official  duty.  And 
first  and  last;  it  is  by  no  means  enough  that  the 
person  to  whom  we  speak  should  listen  as  one  person 
ordinarily  listens  to  another; — he  must  so  listen 
that  our  confusion  clears  itself  away  and  our  uncer- 
tainty is  dispersed. 

When  we  have  this  point  in  view,  we  better  under- 
stand what  I  referred  to  by  way  of  introduction — 
the  difficulty  psychotherapy  has  had  to  make  itself 
free  from  primitive  ideas.  The  confessional  from 
olden  time  belonged  to  the  priest,  and  it  still  does  so 
in  many  countries.  And  this  although  it  is  really  as 
absurd  to  beg  the  priest  to  listen  to  the  agony  of 
the  mind  as  it  would  be  to  ask  him  to  listen  to  the 
heart  in  order  to  determine  if  its  valves  are  sound. 
The  priest  lacks  the  scientific  education  necessary  to 
be  able  to  decide  if  an  affliction  is  determined  phys- 
ically or  psychically — and  this  scientific  education 
must  always  remain  the  starting  point  of  each  in- 
vestigation. Far  from  signifying  a  work  toward 
individual  liberation,  the  confessor's  study  is  turned 
toward  forcing  existence  into  a  system  of  thought 


Points  of  View  and  Outlooks  825 

which  has  little  value  in  the  life  of  our  times.  And 
his  activity  is  bound  up  with  a  vow  to  preserve  this 
thought  system.  Face  to  face  with  the  individual 
human  being's  pain,  the  question  with  him  never  be- 
comes one  of  how,  through  liberation  of  the  cramped 
forces,  he  may  be  able  to  reach  out  toward  healthful 
life-work  and  harmony; — it  means  only  a  dragging 
forth  of  old  doctrinal  phrases,  in  the  hope  that  they 
may  be  able  to  bring  some  comfort.  That  which 
gives  courage  and  strength  is  a  feeling  of  personal 
value,  which  the  psychotherapist  strives  to  present 
when  he  clears  up  causal-connection  complications 
and  shows  that  the  sufferer  has  been  a  victim  of  con- 
flicts and  misconceptions; — on  the  other  hand  there 
is  nothing  so  humiliating  for  such  a  sufferer,  as  to 
hear  his  inner  struggle  for  freedom  summarily  dis- 
missed with  a  few  moral  phrases. 

This  circumstance  becomes  even  plainer  if  we  con- 
sider the  question  of  redemption. 

This  is  the  confessional's  final  goal.  And  it  is 
arrived  at  through  the  idea  that  the  priest,  by  means 
of  some  mystic  power,  confers  remission  of  sins.  It 
does  not  need  to  be  pointed  out  that  the  priest  there- 
by betrays  his  descent  from  the  magic  wizard,  and 
that  this  point  in  the  religious-system  is  a  remnant 
of  the  oldest,  most  primitive  of  ideas.  Inner  redemp- 
tion is  a  psychologic  process,  which  in  the  same  de- 
gree as  other  processes  is  open  to  research.  We  can 
investigate  the  roads  upon  which  those  who  have 


826      History  and  Practice  of  Psychanalysis 

attained  most  in  spiritual  redemption,  searched 
toward  their  goal — we  can  find  certain  genera],  fea- 
tures which  can  be  applied  to  others  and  help  less 
happily  circumstanced  individuals  on.  I  have  al- 
ready shown  how  this  instruction  in  the  art  of  inner 
redemption  is  an  important  component  part  in 
psychotherapy.  In  that  way  we  attempt  to  make  the 
happiest  hours  which  the  strong  experience,  gen- 
eral property; — we  proceed  from  the  undisturbed 
fact  that  the  strong  in  this  succeed  in  casting  away 
the  burden  of  suffering  under  the  weight  of  which 
others  have  gone  to  pieces.  We  ask  how?  And  we 
seek  the  answer  through  analytical  research.  We 
say —  "There  is  the  road !"  And  if  it  turns  out  im- 
passible, in  any  case  we  do  not  tire  of  pointing  out 
the  fact  that  it  nevertheless  is  there. 

But  it  serves  little  advantage  to  talk  of  this  thing. 
Already  for  centuries  mankind  on  its  onward  path, 
has  seen  into  that  which  is  absurd  and  demoralizing 
in  the  confessional.  That  the  confessional  has  been 
able  in  so  widespread  a  degree  to  prevail,  is  alto- 
gether dependent  upon  the  tenacity  with  which  the 
folk-consciousness  clings  to  a  thing  which  is  well 
worked  into  it — and  nothing  can  alter  this.  But 
what  these  people  have  not  understood,  is  how  to 
estimate  the  necessity  that  ultimately  lies  at  the 
foundation  of  the  confessional;  had  they  done  that, 
they  would  have  understood  also  that  this  too  must 
in  some  way  be  looked  after.  The  fact  is  that  the 


Points  of  View  and  Outlooks  327 

confessional  has  more  and  more  been  put  over  upon 
the  physician.  With  or  against  his  will  the  family 
doctor  often  is  dragged  into  all  the  conflicts  and  sor- 
rows that  ultimately  lie  at  the  bottom  of  those  dis- 
turbances for  which  he  has  been  consulted.  In  this 
very  fact  is  already  a  step  ahead.  Unfortunately 
the  doctor,  because  of  the  strong  material  features 
incident  to  his  whole  education,  has  difficulty  in  esti- 
mating psychic  factors  at  their  full  value;  besides 
how  is  he  to  give  himself  time  to  hear  everything  a 
patient  has  to  tell?  His  time  is  already  over- 
full of  things  which  more  directly  fall  into  his  sphere 
of  action.  Intimate  conversation  is  to  him  always 
something  incidental.  It  is,  however,  to  this  actual 
transference  of  the  confessional  from  priest  to  doc- 
tor, from  religion  to  science,  that  psychotherapy  is 
connected.  Its  development  consists  only  in  that  it 
changes  into  something  of  especial  import  what  to 
the  doctor  in  general  has  been  a  minor  thing,  a  trifle, 
and  that  it  puts  forward  especial  training  toward 
this  end  as  a  deliberate  intention.  And  it  is  psych- 
analysis  which  at  this  point  has  been  the  lever  of 
the  development ;  for  it  has  brought  to  light  the  ab- 
solute necessity  of  mutual  discourse  for  the  bringing 
about  of  psychic  health. 


However  psychanalysis  is  something  more  than  the 
drawing  forth  of  everything  that  has  disturbed  a  life 


328      History  and  Practice  of  Psychanalysis 

in  its  making  and  that  has  led  unfoldment  of  this 
life  astray.  It  does  not  limit  itself  to  the  throwing 
of  light  upon  what  is  dragged  out  of  dark  nooks 
and  corners,  whither  an  effort  has  been  made  to  force 
it  back; — it  strives  before  all  after  what  its  name 
implies,  viz :  the  breaking  up  of  that  which  is  brought 
to  light. 

Even  in  this  regard  psychanalysis  is  connected 
directly  with  a  primitive  life-factor.  As  far  back  as 
it  is  possible  to  trace  culture,  one  may  also  plainly 
trace  a  certain  tendency  among  its  first  representa- 
tives toward  introspection,  a  tendency  to  ponder  over 
what  happened  in  the  inner  life.  It  has  not  merely 
been  a  question  of  becoming  lost  in  that  inner  life — 
a  longing  after  an  intensified  perception  of  all  its 
workings;  it  has  been  an  attempt  to  take  hold  of 
these  workings  intellectually  and  to  break  them  up 
into  their  elementary  factors.  This  destructive  inner 
activity  has  grown  into  the  consciousness  as  some- 
thing so  self-evident,  that  we  do  not  even  reflect  upon 
the  fact  that  in  reality  it  is  something  unnatural. 
The  one  thing  natural,  the  one  thing  which  spontane- 
ously awakens  happiness  and  makes  life  richer,  is  the 
free  expression  of  those  forces  which  come  from  our 
inner  life — they  may  seek  their  outlet  in  the  form 
of  contemplation,  of  impulses,  of  activity.  To  thus 
turn  ourselves  against  life's  forces  as  against  enemies, 
to  try  to  grind  them  to  pieces  .  .  .  like  everything 
unnatural  this  produces  aversion  for  life.  And  still 


Points  of  View  and  Outlooks  329 

this  analytical  feature,  which  is  found  among  the 
upholders  of  culture  in  all  times  must  have  authoriza- 
tion. We  come  clearly  upon  it  when  we  examine  the 
individual  thinkers ;  we  find  how  they  carry  on  some- 
thing in  the  unconscious  mind  that  leaves  them  no 
peace — thoughts  perpetually  circle  around  this  thing 
— it  is  a  problem  they  must  have  solved.  What  is  the 
single  individual  but  a  symbol  of  the  whole?  In 
each  muser  is  mirrored  the  suffering  that  burdens 
all, — the  same  riddle  over  which  mankind  as  a  whole 
has  brooded,  generation  after  generation,  comes  back 
to  each  and  every  one  of  them. 

This  compulsion  toward  self-analysis  increases 
during  all  phases  of  unfoldment  which,  more  than 
others,  form  boundary  lines  between  something  that 
has  been  and  something  that  is  to  be.  It  may  be  hard 
to  find  a  time  when  this  fact  has  been  more  evident 
than  in  the  present.  Ever  since  Rousseau  dissected 
and  laid  bare  his  morbid  impulses  and  his  most  inti- 
mate feelings,  numberless  writers  have  freed  their  in- 
ner lives  with  similar  unmercifulness.  And  this  has 
won  response; — those  who  have  gone  the  farthest 
have  been  the  most  highly  esteemed.  One  does 
not  need  to  mention  other  names  than  Ibsen, 
Nietzsche,  Strindberg,  Dostojewski.  It  is  as  if  the 
need  of  clear  inner  vision  forced  itself  out  with  such 
strength,  that  all  other  considerations  must  retire 
into  the  background. 

To   this  feature  also  psychanalysis  joins  itself 


S80     History  and  Practice  of  Psychanalysis 

That  it  has  attained  such  rapid  and  surprising  re- 
sponse, is  largely  because  it  has  been  prepared  for 
in  this  way,  in  the  general  consciousness.  But  it  is 
still  more  because  of  something  else;  it  breaks  open 
a  new  road  for  analysis.  Instead  of  being  handled  as 
hitherto,  by  individual  thinkers  and  writers,  it  now 
becomes  an  object  for  joint  research.  It  no  longer 
is  the  thought  property  of  single  individuals — it  is  a 
question  of  co-operative  work  on  the  broadest  basis. 
Just  as  every  one  in  the  dream  becomes  spontane- 
ously a  poet,  who  conjures  out  symbols  and  meta- 
phors which  in  depth  and  clearness  often  eclipse  the 
best  that  acknowledged  writers  have  succeeded  in 
bringing  forth,  so  each  one,  through  dream-analysis, 
may  become  a  thinker  who  assists  in  spreading  light 
over  the  unknown.  When  everything  that  in  this 
way  becomes  manifest,  is  gathered  together  and  ar- 
ranged, there  arises  hope  that  the  analytical  ten- 
dency in  this  new  system  of  co-operation  may  suc- 
ceed in  reaching  out  toward  a  goal,  which  hitherto 
has  constantly  disappeared  as  an  illusion.  Thus 
far  psychanalysis  has  indeed  already  shown  itself  to 
be  something  other  than  empty  illusion,  since  every- 
one, who  with  comprehension,  has  followed  Freud's 
researches  may  get  gratifying  answers  to  many  hith- 
erto obscure  life  problems. 

I  shall  not  again  touch  upon  any  of  the  details 
of  psychanalysis.  Only  at  one  point  I  must  pause. 

What  first  is  most  striking  in  a  cursory  glance 


Points  of  View  and  Outlooks  331 

over  Freud's  work,  is  his  emphasizing  of  the  power 
of  the  past  over  us.  The  man  of  action,  who  lives 
in  the  general  whirl  and  never  takes  thought  of  any- 
thing other  than  how  he  may  get  along  from  day  to 
day,  does  not  notice  this  power.  The  neurasthenic, 
on  the  contrary,  who  incessantly  works  up  his  experi- 
ences in  order  to  fret  over  now  one,  now  another  of 
them,  is  over-sensitive  to  this  fact.  Be  the  case  one 
way  or  the  other,  the  past  always  binds  us  and  rises 
like  a  wall  in  the  way  of  that  to  which  we  wish  to 
attain.  Even  where  activity  continues  free,  the  past 
influences  it,  in  all  details.  One  intelligent  man,  of 
great  energy,  said  to  me  when,  during  analysis,  he 
became  aware  of  this  fact:  "But  then  surely  every 
one  ought  to  undergo  psychanalysis  once  a  year,  in 
order  to  discover  the  real  motive  for  his  actions." 
It  is  certain  that  consistent  searching  through  of  all 
the  obscurity  which  drives  and  hunts  us  on,  should 
relieve  our  daily  life  of  much  confusion. 

"That  which  is  bound  on  earth  shall  be  bound  in 
heaven."  This  sentence  may  here  be  repeated  only 
with  the  difference  that  in  the  place  of  earth  and 
heaven,  we  use  the  words  childhood  and  the  life  that 
succeeds  it.  It  is  simply  out  of  all  that  which  is 
built  up  during  the  first  years,  that  opposition  to  life 
is  chiefly  derived.  What  is  disastrous  is  that  this 
constructive  work  is  not  led  by  the  same  rationality 
that  later  is  to  be  the  deciding  factor ; —  it  is  led  by 
a  consciousness  that  has  not  learned  to  separate  fact 


332      History  and  Practice  of  Psychanalysis 

from  fantasy,  reality  from  unreality.  In  all  neuroses 
this  fragment  of  the  childhood-life  plays  a  certain 
part;  in  all  the  peculiar  ideas  of  neurotics  it  re- 
mains and  blocks  the  path  for  the  free  building  up  of 
the  "I."  It  represents  an  opposition  against  which 
the  forces  in  vain  are  broken  in  their  struggle  toward 
an  ideal  which  has  developed  during  the  years  of 
growth.  Often  enough  one  may  see  how  disharmony 
has  its  root  in  this  strife  between  the  child  in  man 
— its  world  of  illusion  and  manner  of  feeling  toward 
life  on  the  one  hand — and  on  the  other  the  reality 
in  which  the  grown  person  tries  to  arrive  at  harmony. 
On  earth — in  heaven ; — who  knows  if  it  is  not  simply 
this  bondage  to  what  one  thought  and  felt  before 
one  yet  was  an  independent  being  who  could  feel 
and  think  for  himself,  that  more  than  anything  else 
prevents  the  world  from  becoming  a  dwelling  place 
of  harmony? 

I  have  said  before  what  Freud's  incest-doctrine 
seems  to  me  to  imply,  if  one  strips  it  of  its  extraor- 
dinary terminology.  It  places  the  inscrutability  of 
the  impulse  before  one's  eyes  and  shows  us  how  sat- 
urated with  fate  is  the  early  anchorage  of  the  feel- 
ings. There  is  something  fearful  in  all  this.  Freud 
has  laid  bare  chasms  and  exhibited  tragic  depths  be- 
fore which  we  ask:  "How  shall  any  one  be  able  to 
escape  this  thing?"  There  is  nothing  farther  from 
Freud  than  a  therapeutic  enthusiasm  which  works 
every  success  in  practice  up  to  a  new  illusion.  Thus 


Points  of  View  and  Outlooks  333 

psychotherapy  is  made  ridiculous  if  any  one  imputes 
to  its  ability  to  "cure"  all  or  even  half  of  the  suffer- 
ing that  falls  within  its  sphere.  Whoever  takes  up 
this  work  must  surely  soon  enough  obtain  insight  into 
the  cruelty  of  life  and  the  perishableness  of  hope. 
But,  and  this  is  perhaps  the  greatest  thing  in  Freud's 
work, — it  is  only  through  the  unyielding  truth,  that 
a  way  is  opened  to  freedom ;  it  is  only  after  one  lays 
life  bare  in  its  most  horrid  nakedness  that  one  may 
hope  to  come  to  rights  with  it.  Every  system  of 
philosophy  built  on  lies  is  bad  philosophy.  On  a 
foundation  of  lies  one  may,  possibly  drag  himself 
along  from  the  jugglery  of  one  day  to  that  of  the 
next;  but  to  so  reach  a  state  of  existence  worthy  a 
human  being — never. 

It  is  interesting  to  note  how  psychanalysis  even 
at  this  point,  takes  up  and  drives  to  its  extremity  a 
movement,  that  already  occupies  a  widespread  space 
in  cultural  life ;  I  refer  to  the  attempt  to  find  out  the 
real  life  of  the  child  and  to  help  it  on  to  early  indi- 
vidual freedom,  instead  of  holding  it  back  in  the 
thought-  and  feeling-life  of  childhood.  "I  have  al- 
ready shown  how  the  application  of  psychanalysis 
to  pedagogics  is  one  of  its  most  important  sides. 
Just  as  Rousseau  when  he  became  conscious  of  the 
misery  of  his  own  life,  turned  his  interest  toward  the 
training  of  children,  so  the  enlightenment  received 
from  psychanalysis  must  be  directed  toward  the  same 
end.  For  the  individual  alone  it  may  seem  as  if  there 


334     History  and  Practice  of  Psychanalysis 

were  little  comfort  in  this — his  own  fate  remains  in- 
deed, just  the  same.  And  among  all  those  things 
which  rest  heavily  upon  and  oppress  us,  this  feeling 
is  perhaps  the  crudest  of  all;  so  it  is  and  so  it  will 
always  be.  If  we  can  look  with  a  brighter  eye  toward 
the  generation  to  come,  something  at  least  of  the 
agony  of  life  is  dissipated  and  we  may  breathe  more 
easily. 


However  this  bondage  and  opposition  to  life's 
current  originates  not  only  in  childhood.  In  neu- 
rotics there  remains  like  a  block  in  the  conscious- 
ness, not  simply  an  unmelted  piece  of  this.  Freud's 
latest  researches  go  to  show  that  even  a  bit  of  primi- 
tive man's  world  is  left  in  neurotics  and  holds  them 
down.  He  has  presented  numerous  analogies  be- 
tween savage  conceptions,  feelings  and  circum- 
stances, which  appear  in  compulsion-conditions  and 
other  nervous  symptoms.  Something  holds  good 
here,  similar  to  the  experiences  of  childhood;  fan- 
tasies, imaginations,  impulses,  symbols,  work  them- 
selves together  and  construct  a  whole  system,  which 
remains  established  long  after  the  different  units  have 
lost  their  real  significance.  As  one  individual  may 
be  burdened  by  that  which  he  built  up  and  grew  into 
during  childhood,  so  we  may  all  be  burdened  con- 
tinually by  the  dead  remains  of  the  childhood  of 
humanity. 


Points  of  View  and  Outlooks  335 

It  does  not  need  pointing  out  that  psychanalysis 
also  in  its  attempt  to  investigate,  dissolve  and  an- 
nihilate all  this,  adds  to  the  prevailing  cultural  life. 
It  makes  a  tendency  conscious  which  acted  uninter- 
ruptedly during  many  centuries,  and  it  shows  its 
deep  importance. 

In  the  face  of  the  enormous  efforts  investigators 
have  made  to  work  out  and  reconstruct  in  minutest 
detail  the  past  folk-life,  many  soundly  skeptical  peo- 
ple have  asked :  To  what  end  is  all  this  ?  We  surely 
do  not  live  to  dig  out  ruins  which  cannot  in  the 
slightest  degree  produce  new  results ;  how  much  more 
important  is  it  that  we  should  devote  our  forces 
toward  the  formation  of  something  which  can  give 
us  safety  and  happiness.  Does  not  the  man  who 
busies  himself  with  such  things  resemble  the  neu- 
rotic who  constantly  digs  into  his  own  morbid  inner- 
life  instead  of  turning  himself  outwards  and  enjoying 
the  sun's  warmth  and  all  that  grows  therein?  In  a 
certain  degree,  yes.  But  as  the  neurotic  must  arrive 
at  a  clear  understanding  of  something  in  order  to 
become  free  from  it,  so  must  humanity  bring  to  light 
the  hidden  foundation  of  its  life  so  that  it  may  cast 
off  that  which,  stretching  itself  up  out  of  the  past, 
holds  it  in  bondage. —  In  order  to  see  this  connec"- 
tion,  one  need  think  only  of  the  old  religious  dogmas. 
All  attacks  against  them  amounted  to  little  before 
higher  criticism  of  the  Bible  came  and  broke  them 
up.  Then  disappeared  into  thin  air  and  became  only 


336     History  and  Practice  of  Psychanalysis 

legends  and  fantasies  much,  which  hitherto  had  lived 
in  the  consciousness  as  tangible  reality. 

While  psychanalysis  makes  us  more  conscious  of 
the  deep  import  of  research  work  it  drives  its  eman- 
cipating tendencies  to  the  extreme  limit;  it  carries 
it  all  the  way  down  into  those  psychic  elements,  the 
syntheses  of  which  construct  the  foundation  for  our 
ideas. 


But  psychanalysis  means  still  something  more  than 
this  dragging  forth  of  psychic  material  and  its  dis- 
solution into  simpler  factors;  it  means  also  an  in- 
terpretation of  these  forces  of  the  depths.  And  in 
most  cases  this  means  a  re-interpretation,  a  re-valua- 
tion. 

It  was  chiefly  through  the  necessity  of  drawing 
the  dream-life  into  analysis  that  we  were  forced  to 
put  interpretation  procedure  into  the  foreground. 
In  this  field  we  may  see  also  more  plainly  what  it 
means.  Dreams  come  into  the  consciousness  as  a 
meaningless  jumble  of  unconnected  pictures;  by 
means  of  interpretation  the  real  content  is  brought 
to  light,  and  through  interpretation  the  connection 
and  meaning  becomes  apparent.  Thus  we  find  that 
the  apparently  unimportant  pictures  are  something 
else  than  visions  whirled  about  by  chance;  they  are 
symbols.  And  behind  these  symbols  are  hidden  some- 
thing most  deeply  essential. 


Points  of  View  and  Outlooks  337 

It  is  an  especially  important  thing  that  research 
turned  so  directly  toward  the  interpretation  of  sym- 
bols. To  me  it  seems  to  have  come  upon  the  nucleus 
of  the  matter  there. 

While  speaking  of  this  in  the  foregoing  pages,  I 
pointed  out  the  connection  between  earlier  ways  of 
representation  and  our  dream  symbols.  This  had 
before  been  suspected,  but  no  one  had  been  able  to 
explain  it  as  comparative  analytical  research  has 
done.  Nietzsche,  for  example,  dared  give  out  that 
bold  saying  of  his  that  the  world  in  which  we  live 
during  dreams  was  the  only  world  known  to  primi- 
tive people — i.  e.  that  we  fall  back  during  sleep  tem- 
porarily to  their  form  of  life,  we  make  use  of  their 
form  of  expression.  This  principle  ought  to  broaden 
our  view  for  what  is  accidental  in  the  world  we  be- 
lieve we  experience  as  final  reality.  No  educated 
person  is  likely  in  these  days  to  take  the  external 
world  for  exactly  that  reality  it  seems  to  us  to  be; 
it  is  the  appearance  of  something  unknown — it  is 
finally  a  symbol  which  we  cannot  interpret.  The 
great  transformation  human  consciousness  under- 
went, from  the  time  the  world-ideas  were  formed  ac- 
cording to  the  present  laws  of  the  dream-life  and  to 
the  era  of  philosophical  thinking,  thus  essentially 
consists  in  the  creating  of  new  symbols.  In  place  of 
those  fleeting  symbols  mainly  consisting  of  simple 
sensuous  perceptions,  more  lasting  ones  have  been 
constructed,  those  stamped  by  the  intellectual  life 


838     History  and  Practice  of  Psychanalysis 

predominating;  affect  symbolism  has  been  compen- 
sated for  with  science,  which  opens  out  into  the 
material  world. 

Simultaneously  with  this  change  an  effort  has  also 
gone  on  to  interpret  the  different  symbols.  People 
are  not  content  with  experiencing  existence  in  one  or 
another  form ;  they  will  have  established  also  the  con- 
nection and  meaning  in  what  they  experience. —  Just 
as  psychanalysis  everywhere  unites  to  primitive  life- 
factors  and  intentionally  broadens  and  in  a  certain 
degree  completes  them,  so  it  also  does  here.  It  takes 
up  this  more  indefinite  effort  to  interpret  the  world 
experience  and  makes  thereof  a  methodical,  fully  con- 
scious symbol-research.  Whither  our  co-operation 
towards  the  attainment  of  the  goal  will  lead,  no  one 
can  now  prophecy ;  but  if  it  serves  any  good  purpose 
it  must  be  carried  far  beyond  the  boundaries  Freud 
has  staked  out. 

The  greatest  fault  with  Freud  is  that  he  has 
squeezed  even  the  interpretation  of  symbols  into  his 
sexual  doctrine. 

In  the  solitary  dream-symbol,  all  of  that  life  which 
in  the  waking  state,  we  spread  out  over  space  and 
time,  seems  pressed  together  into  a  single  picture. 
This  picture  gives  a  synopsis  of  the  situation  in 
which  for  the  moment,  we  find  ourselves; — in  inter- 
pretating  the  picture  we  must  take  into  consideration 
all  those  factors  which  play  a  part  in  it.  The  new- 
est branch  in  psychanalysis,  that  which  has  its  cen- 


Points  of  View  and  Outlooks  339 

ter  in  Zurich,  and  is  represented  by  Jung,  Maeder, 
Riklin  and  others  are  striving  after  just  this.  It  is 
to  the  merit  of  Adler  that  we  have  left  behind  Freud's 
sexual  doctrine;  it  is  the  effort  of  this  branch  to 
overcome  Adler's  one-sidedness  also. 

I  have  said  in  connection  with  the  "rational" 
method  of  treatment  that  every  persuasion  must  al- 
ways be  brought  out  of  the  patient's  own  psyche. 
The  same  thing  holds  good  where  it  is  a  question  of 
finding  the  true  clue  for  interpertation.  And  it  is 
in  this  case  even  more  momentous,  inasmuch  as  it  has 
to  do  with  deeper  things.  Psychanalysis  aims  not 
only  at  the  interpretation  of  single  dream-symbols  or 
single  neurotic  symptoms;  it  endeavors  as  its  final 
aim,  to  set  forth  the  right  interpretation  of  all  those 
forces  which  wrestle  within  the  patient — to  show  him 
what,  in  his  inmost  heart,  he  most  ardently  yearns 
for.  It  tries  in  this  way  to  reunite  him  with  reality 
and  it  appears  thereby  not  only  as  the  central  point 
in  psychotherapeutics ;  it  reveals  its  indissolvable 
connection  with  the  most  essential  aim  of  all  cultural 
progress. 


It  seems  to  me  that  the  future  of  psychotherapy 
mainly  depends  upon  certain  inner  qualifications.  It 
means  a  self-perfection  that  is  realized  in  the  degree 
one  finds  what  is  most  essential  in  the  various  cur- 


840     History  and  Practice  of  Psychanalysis 

rents  and  leads  these  to  flow  harmoniously  together. 
All  trifling  arguments  must  be  overcome.  Only  such 
an  inner  development  can  give  the  movement  enough 
strength  to  break  the  external  opposition. 

This  can  be  found,  and  this  must  be  found. 

The  medical  corps  itself  as  a  rule,  still  meets  the 
effort  to  construct  a  new  branch  of  therapeutics  with 
a  blending  of  the  indifference  with  which  the  very 
earliest  attempts  in  the  same  direction  were  met  and 
the  attempt  towards  annihilation  with  which  Freud 
is  constantly  beset.  This  does  not  at  all  imply  that 
there  are  not  many  members  of  that  corps  who  suffer 
because  of  the  powerlessness  of  physical  therapeutic 
measures  against  neurosis,  and  who  with  interest 
grasp  each  new  possibility,  including  those  coming 
from  this  direction.  But  strangely  enough  this  in- 
terest is  met  with  least  among  those  who  ought  to 
be  most  interested,  that  is  to  say,  among  neurolo- 
gists and  alienists.  The  official  position  which  these 
adopt  towards  psychanalysis  is  everywhere  evident, 
and  this  is  partly  because  they  are  as  strongly  en- 
trenched in  material  phenomena  as  their  colleagues, 
partly  because  they  especially  have  to  do  with  such 
forms  of  mental  and  nervous  disease  that  treatment 
of  any  sort  is  unavailing. 

While  the  attitude  of  the  profession  towards 
psychotherapy  is  of  great  importance,  nevertheless 
everything  does  not  hinge  upon  it.  We  must  not  for- 
get that  many  different  elements  enter  into  this  sub- 


Points  of  View  and  Outlooks  341 

ject,  which  as  a  matter  of  fact  lie  outside  the  bound- 
ary lines  of  traditional  medicine.  Psychotherapy 
tries  in  its  sphere  of  activity  to  gather  together  and 
perfect  life-factors  which  hitherto  have  belonged  else- 
where. It  is  more  important  therefore  what  stand 
people  in  general  take  regarding  it  than  what  view 
a  limited  professional  circle  adopts. 

In  raising  one's  self  in  opposition  to  psycho- 
therapy one  overlooks  all  too  easily  that  its  funda- 
mental factors — suggestion,  analysis,  symbol-inter- 
pretation, etc., — already  exist  as  actual  forces  in  the 
consciousness.  And  not  only  do  they  so  exist  but 
they  push  a  way  out  with  demand  for  realization, 
which  in  course  of  time  cannot  be  repressed.  Modern 
life  with  its  rude  objectivity, has  of  necessity  dragged 
with  it  not  only  a  belittling  of  the  inner  intimate  ex- 
istence, but  also  a  brutalizing  of  all  that  care  of 
the  soul-life  which  in  former  times  went  before  every- 
thing else.  Psychotherapy  is  trying  in  new  ways  and 
under  new  forms  to  recommend  cures  for  the  evils  of 
the  times  and  in  this  way  to  fulfill  one  of  its  most 
grave  demands.  Present-day  people  who  feel  their 
souls  stifled  in  this  world,  which  more  and  more  is 
stamped  by  mechanical  technique,  yearn  for  what 
really  lives  and  moves,  feeling  but  one  thing  neces- 
sary, namely:  the  care  of  that  which  has  awakened 
and  wishes  to  grow  in  the  unfathomable  depths  of 
the  mind. 

It  is  to  the  call  for  the  cure  of  souls  in 


342      History  and  Practice  of  Psychanalysi* 

the  highest  sense,  that  the  psychotherapist  seeks  to 
find  an  answer.  Even  if  th£  search  towards  it  thus 
far  has  its  great  defects — that  is  no  reason  why  the 
work  should  not  be  carried  on.  Those  who  toil  in 
this  direction  should  take  into  consideration  that  at 
the  same  time  they  try  to  destroy  the  longing  which 
the  answer  means. 

But — it  must  be  conceded — psychotherapy  among 
the  general  public  meets  with  no  such  violent  opposi- 
tion as  a  new  movement  does  meet  with  customarily. 
This  is  chiefly  because  it  is,  in  the  whole  of  its  na- 
ture, so  little  aggressive.  As  it  has  to  do  with  the 
improvement  of  the  single  individual,  so  also  in  a 
broad  view  it  has  to  do  with  a  positive  purpose ;  the 
creating  of  something  that  is  not,  instead  of  the  de- 
molishing of  something  already  extant. 

There  is  perhaps  really  only  one  thing,  that  psy- 
chotherapy must  turn  itself  against.  And  that  is 
against  every  tendency  to  preserve  worn-out  forms 
of  the  religious  life. 

The  analysis  of  consciousness  has  beyond  meas- 
ure made  clear  the  apodictic  power  of  the  past. 
Each  effort  to  preserve  something  which  no  longer 
has  living  force — which  does  not  harmonize  with  all 
our  ways  of  thinking  and  feeling — which  does  not 
move  our  hearts  and  bear  us  on  towards  clearer  un- 
derstanding;— every  such  effort  is  a  power  that 
fetters  the  mind  and  drives  the  mind  so  fettered,  down 
towards  destruction. 


Pomts  of  View  and  Outlooks  343 

I  come  again  here  to  the  same  idea  with  which  I 
began. 

Psychotherapy  must  not  only  endeavor  to  make 
free  the  soul-life  and  to  guard  it  from  all  primitive 
conceptions  that  still  live  in  modern  layers  of  the  old 
religious  systems;  it  must  try  to  drive  this  effort, 
which  has  been  going  on  for  centuries,  towards  a  defi- 
nite goal.  It  is  unnecessary  to  point  out  that  while 
this  implies  a  freeing  of  the  deepest,  noblest  forces 
in  human  nature,  it  also  implies  a  liberating  of  all 
that  for  which  humanity  has  yearned  when  it  sought 
the  divine. 

The  struggle  against  spiritual  death,  the  strife 
after  purity,  clearness  of  vision,  freedom,  these  will 
always  remain  psychotherapy's  alpha  and  omega,  let 
it  assume  what  temporary  forms  it  may,  in  different 
times  and  in  various  hands. 


INDEX 


Abraham,  87 

Albreaction,  93,  98,  137,  138 

ABLER  DOCTRINE  CON- 
CERNING NEUROSIS, 
152-197 

Adler's  conception  of  the  life 
plan,  193,  194,  226 
separation  from  Freud,  88, 
152,  158 

Agorophobia,  173 

Alcoholists,  '209 

Anal-erotism,    128 

Application  of  psychanalysis 
to  pedagogics,  143,  144,  333 

Auto-erotism,  128,  130,  133 

Automatism,  213 

B 

Beaunis,  60 

Bernheim,  59,  60,  79,  198 
Bernheim's  books,  86 
Bethesda,  The  new,  52 
Bjornstrom,  71 
Braid,  56,  57,  58,  67,  80 
Bramwell,  58,  69 
Breuer,  85,  86 
Breuer's  case,  85,  92 
use  of  hypnotism,  85 


Cardinal  point  of  psychana- 
lytical  therapy,  232 

CASE  HISTORY,  EX- 
TRACT FROM  A,  248-297 


Catalepsy,  212 

Cathartic  method,  103,  104 

Causal    view-point,    156,    192, 

196 
Censoring  in  dreams,  87,  108, 

110 
Charcot,   60,   69,   78,   86,    156, 

230 

Childhood   trauma   and   post- 
hypnotic  suggestion,  322 
Christian  Science,  22,  23,  299, 

300 
Cicero,     Kant's    use     of     the 

word,  19,  23 
Clairvoyance,  215 
Complex,  93,  95,  98,  132,  134, 

225,  233 

Compensation,  159,  160,  167 
Compulsion      fantasies,      223, 

225, 

system,  185 

Concentration,  203,  212 
Condensation,  108,  112 
Confessional,    323,    324,    325, 

326 
CONSCIOUS  VERSUS  THE 

UNCONSCIOUS,    218-247 
Conscious   life,   150,   151,   153, 

236 

Consciousness,  202,  207,  243 
Conversion,  95,  96,  98 
Copernicus,  21 
Curtailment      of      treatment, 

240,  241 

.D 

Dangers     of     treatment     by 
psychanalysis,  146,  147,  148 


345 


346 


Index 


Defense-mechanism,   172,   173, 

174,  175,  183,  184,  187 
Degeneration,  161,  167,  175 
Dejerine,  305 

Displacement,  108,  109,  167 
Dramatization,  108,  109 
Dostojewski,  329 
Dreams,    105,    106,    107,    108, 

109,  110,  111,  112,  113,  114, 

150,  154,  336 
Dreams  and  insanity,  112 

construction  of,  108 

interpretation  of,  105,   106, 
107 

psychological    processes    in, 
108 

use  of  symbols  in,  110,  336 

wish-motive  in,  114,  154 
Dubois,  305,  306,  310 

E 

"Electro-biologists,"   57 
Ellis,   Havelock,  128 
Epilepsy  question,  78,  79 


Fantasy,    165,    166,    167,    168, 

169,  180,  185 
Father-complex,  223,  233,  234, 

241 
Feeling    of    inferiority,     164, 

165,  166,  167,  169,  179,  182, 

183,  187,  188,  189 
Feminist    movement,    Adler's 

idea  of,  178,  179,  180 
Ferenczi,  151,  226,  229 
Fetal  memory  trace,  215 
Feuchtersleben,     Ernst     von, 

20,   27,   28,   29,   31,   33,   35, 

36,  37,  304,  306 
Finality,  192,  196 
Forel,  69 
Folk-consciousness,  50 


Folk-lore,  111 

"For  Pay,"   188,   189 

Foville,   64 

Frank,  316 

Freschl,  188 

Freud,  69,  83,  86,  87,  88,  89, 
90,  91,  92,  93,  94,  95,  97, 
99,  101,  103,  105,  106,  107, 
108,  110,  111,  112,  114,  118, 
120,  121,  125,  126,  127,  128, 
132,  133,  134,  136,  140,  142, 
143,  149,  150,  151,  153,  156, 
157,  188,  190,  192,  235,  243, 
319,  331,  332,  333,  338 

Freud's  catagorical  sentence, 
121 

cathartic  method,  103 
incest     doctrine,     190,     191, 

195,  235,  236,  332 
ingenuity,  112 
one-sidedness,  150,  157,  321 
periodicals,  89 
scientific  honesty,  130 
symptomatology    of   neuro- 
sis, 133 

Freudian  wish,  114,  154 

Fundamental  types,  30,  31 

Future  of  psychotherapy,  339, 
340,  341,  342,  343 


Genius,  161,  167,  175 
Gorki's  "Night  Refuge,"   168 
Gout,  Kant's,  17,  18,  19 

H 

H  allucination,   113 
Hevisi,  54,  55 
Hirschloff,  69,  203,  206 
Hitschmann,  91 
Hoche,  84,  90 
Homo-sexuality,  118,  184 
Hufelend,  18,  27 


Index 


347 


Hypnosis,    79,    80,    101,    198, 

199,  201,  202,  203,  204,  205, 

206,  20T,  208,  210,  314,  315, 

316,  318 
Hypnotic  condition,   199,  316 

suggestion,  66 

treatment,  69 
Hypnotism,  57,  72,  79,  83,  87, 

314 

and  suggestion,  314,  315 

Freud's    reason    for    aban- 
doning use  of,  101,  102 

Wetterstrand's   independent 

idea  concerning,  79,  81 
Hypochondriac,  33 
Hysteria,   characteristics    for, 

133 


Ibsen,   329 

Ibsen's   "Ghosts,"    124 

Illusion,  the  world  of,  165, 
167 

Imago-connections,  242 

Impotence,  cases  of,  175,  177 

Indications  for  treatment, 
145,  146 

Infantile  trauma  and  neuro- 
sis, 121,  125 

Introspection,  100 

Isolation,  203 

Isserlin,  91 


Jones-Hamlet     interpretation, 

106 
Jung,   87,    89,    111,   226,    231, 

236,  339 

K 

Kant,   17,   18,   19,  20,  21,  22, 

23,  24,  25,  26,  39 
KANT  AND  FEUCHTERS- 

LEBEN,  17-42 
Kant's   influence   on    the   de- 


velopment of  psychother- 
apy, 19,  20,  39,  40 

Kant's  psychological  dietetic 
prescription,  23 

Kb'nigsberg,  24 

Krafft-Ebing,   69 


Latent  dream  material,  107, 
108 

Legend  of  paradise,  165 

"Lehrbuch  der  artzliche  See- 
ienkunde*"  Feuchtersleben, 
27 

Li^beault,  23,  49,  51,  58,  59, 
61,  62,  63,  64,  65,  66,  67,  203 

Lidbeault's  definition  of  sug- 
gestion, 166 

Li?beault's  psychology  of  the 
attention,  64,  65 

Li£goise,  60 

Luthur,  127 

M 

Madonna  hallucinations,  143 

Magnatizers,  56 

Maeder,   339 

Manifest  dream  pictures,  107, 

108 

Marcinowski,  306 
Masculine    protest,    171,    175, 

176,  177,  178,  179,  181,  187, 

188 

Memory  traces,  213 
Moll,  69 
Morphinists,  208 
Muthmann,  101 

N 

Nancy-School,  24,  43,  58,  59, 

60,  67,  69,  80,  86 
Narcissism,  130 
NATURE   OF   HYPNOSIS, 

THE,  198-217 


348 


Index 


"Neurhypnology,"  57 
Neurosis,    161,    167,    171,   174, 

216,  225,  229,  241 
Neurotic,  170,  173,  175 

attitude,  176 

conditions,  185,  241 
Nietzsche,  306,  329,  337 
Nirvana,  201,  202,  212 


(Edipus-Complex,     134,     136, 

141 
Organic  defect,  161,  162 


Reality,    165,    167,    168,    175, 

226,  231,  232,  234,  236,  239, 

261,   262 

Regression,    181,   242 
Religion  and  therapeutics,  70, 

268,  269,  298,  299,  302,  342 
Repression,  93,  94,  97,  98,  119, 

120,   131,   140 
Repressed  wishes,  230 
Resistance,  228 
Results  reached,  145,  146 
Re-valuation,  302,  336 
Riklin,  339 
Rousseau,  329,  333 


Persecution-complex,  292,  293 
Persuasion   method,   308,   309, 

310,  312 

Phenomena  of  suggestion,  63 
Poet's   faculty,  42 
POINTS    OF    VIEW    AND 

OUTLOOKS,  298-343 
Polymorphic   perversity,   118 
Primal  state  of  rest,  210,  211 
Prolonged  sleep,  80,   199,  319 
Prophylactic  hope,  142 
PSYCHANALYSIS     AS     A 

SCIENCE    AND    METH- 
OD    OF     TREATMENT, 

83-151 
Psychanalytical       periodicals, 

88,  89 
Psychic  epidemic,  53,  84 

types,  185 
Psychology   of   the   attention, 

Liebeault,   64,  65,   66 

of  Freud,   157 
Psycho-therapy,  the  future  of, 

339,  340,  34l 
Puberty,   130 


R 


Raimann,  84 
Rank,  89 


Sachs,  89 

Sadger,  87 

Schisms  in  the  movement,  89 

Schmidkunz,   62 

Schrenk-Notzing,  69 

Science  and  therapeutics,  230 

Scientific  demands,  72 

Self-analysis,  100,  101 

Self  honesty,  101 

Sexual   doctrine,   Freud's,   94, 

126,  127,  128,  129,  130,  131, 

132,  133,  138,  157,  188,  192, 

320 

development,  130 

dogmatism,  190 

unfoldment,    130.    131,    132, 
133,  140 

wish,  114 
Sixtus,  71 
Skin,  63,  212 
Slang,  111 
Somnambulism,  83 
Speech,    disturbance    in,    181, 

182,   183 
Stekel,  87-89 

Strindberg,  170,  188,  189,  329 
Sublimation,  94,  132,  140,  144 
Suggestion,  61,  62,  63,  64,  66, 

67,  68,  70,  80,  148,  311,  320, 

322 


Index 


349 


Suggestive    therapeutics,    70, 

79 

Suicide,  147,  173 
Symbols,  108,  111 
Symbols  in  dreams,  111,  336, 

337,  338 


"Talking-cure,"  85 
Technical  means,  103,  104 
Therapeutic    points    of    view, 

137 

Therapeutics  and  science,  230 
Transference,    132,    140,    242, 

243,  320 

of  father-complex,  223,  233, 

234,  241 

Traumatic  neurosis,  120 
"Traumdeutung,"  106 


U 

Unconscious     material,     228, 
239 

mechanism,  234 
mind,  98,  191,  225,  226,  227 
wish,  114,  190 


"Use  of  Hypnotism  in  Prac- 
tical Medicine,"  71,  78 


Van  Eeden,  69 
Van  Helmont,  64 
Van  Reutergehm,  69 
"Verdrangen,"  93 

W 

Waking  life,  102 
WETTERSTRAND       AND 

THE      NANCY-SCHOOL, 

43-83 

anecdotes  of,  73,  76,  77 
Wetterstrand's  case  histories, 

72 

energy,  81 

letters,  43,  44,  47,  48 
Wild  analysing,  138 
Wish  motive  in  dreams,  114S 

154 
Witticisms,  111 


Zeihen,  101 

Zurich  School,  87,  88,  339 


University  of  California 

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